Laparoscopic Ureteral Reimplantation: Technique and Outcomes

Seideman, Casey A.; Huckabay, Chad; Smith, K.; Permpongkosol, Sompol; Nadjafi-Semnani, Mohammad; Lee, Benjamin R.; Richstone, Lee; Kavoussi, Louis R.

doi:10.1016/j.juro.2008.11.102

Cited by 41 publications

(29 citation statements)

References 15 publications

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“…Following the success in ablative procedures, laparoscopic approach has been increasingly employed for reconstruction of urological pathologies and for reconstruction of lower ureteral strictures, albeit sparingly. [3] Although the projected outcome following laparoscopic reconstruction is promising,[4] citations till date have not focussed on the feasibility of conducting this approach primarily after the inciting event. This paper aims to compare the immediate and long term outcomes following early and delayed laparoscopic repair of lower ureteric strictures.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic reconstruction of iatrogenic-induced lower ureteric strictures: Does timing of repair influence the outcome?

Abraham

Das²,

Ramaswami

et al. 2011

Indian J Urol

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Context:Influence of timing of repair on outcome following laparoscopic reconstruction of lower ureteric stricturesAims:To assess the influence of timing of repair on outcome following laparoscopic reconstruction of lower ureteric strictures in our adult patient population.Settings and Design:Single surgeon operative experience in two institutes. Retrospective analysis.Materials and Methods:All patients were worked up in detail. All patients underwent cystoscopy and retrograde pyelography prior to laparoscopic approach. Patients were categorised into two groups: early repair (within seven days of inciting event) and delayed repair (after two weeks). Operative parameters and postoperative events were recorded. Postprocedure all patients were evaluated three monthly. Follow-up imaging was ordered at six months postoperatively. Improvement in renal function, resolution of hydronephrosis and unhindered drainage of contrast through the reconstructed unit on follow-up imaging was interpreted as a satisfactory outcome.Statistical Analysis Used:Mean, standard deviation, equal variance t test, Mann Whitney Z test, Aspin-Welch unequal variance t test.Results:Thirty-six patients (37 units, 36 unilateral and 1 simultaneous bilateral) underwent laparoscopic ureteral reconstruction of lower ureteric stricture following iatrogenic injury - 21 early repair (Group I) and 15 delayed repair (Group II). All patients were hemodynamically stable at presentation. Early repair was more technically demanding with increased operation duration. There was no difference in blood loss, operative complications, postoperative parameters, or longterm outcome.Conclusions:In hemodynamically stable patients, laparoscopic repair of iatrogenically induced lower ureteric strictures can be conveniently undertaken without undue delay from the inciting event. Compared to delayed repairs, the procedure is technically more demanding but morbidity incurred and outcome is at par.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic reconstruction of iatrogenic-induced lower ureteric strictures: Does timing of repair influence the outcome?

Abraham

Das²,

Ramaswami

et al. 2011

Indian J Urol

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“…Subsequent related publications have presented short series of patients, the largest of which ( n = 45) was presented by Seideman et al . [1]. Previous papers have highlighted the low invasiveness of laparoscopic treatment in comparison with open surgery, comparable functional outcomes, and the low risk of subsequent complications along with the necessity of wide experience with the laparoscopic technique [1–5].…”

Section: Discussionmentioning

confidence: 99%

“…Ureterocystoneostomy is the widely accepted treatment method for distal ureteral strictures [1]. Apart from simple anastomoses, the classical open method is useful for performing complex techniques such as vesico-psoas hitch, Boari flap, supplementing the ureteral defect with part of an intestine, or even renal autotransplantation [2].…”

Section: Introductionmentioning

confidence: 99%

Simplified laparoscopic technique for the treatment of long distal ureteral stenosis.

Gołąb

Słojewski

Sikorski

2013

Videosurgery and Other Miniinvasive Techniques

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Laparoscopic interventions with the application of vesico-psoas hitch and Boari flap methods for the reconstruction of pronounced ureter defects require considerable physical skill and competence. This case series aims to present our experience in the treatment of long, distal ureteral stenoses via simplified laparoscopic ureteroneocystostomy in 3 male patients in whom the stenoses ranged from 5 cm to 6 cm. Prior to each laparoscopic intervention, intravenous urography and pyelography via a nephrostomy tube were performed. The mean operation time was 157 min (120–180 min), and blood loss averaged 33 ml (20–50 ml). No intra-operative or post-operative complications were recorded. The post-operative hospital stay was ≤ 6 days. Follow-up imaging examinations revealed normal kidney-urinary bladder urine flow in all cases. In conclusion, we consider that simplified ureteral replantation facilitates laparoscopic treatment of long, distal ureteral stenoses.

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“…The indications for ureteral reimplantation include distal strictures secondary to pelvic surgery, endoscopic procedures, endometriosis, and distal ureteral tumors [1,2,3,4,5]. Unfortunately, more and more ureteroneocystostomies have been performed and most of these procedures can be attributed to iatrogenic ureter injuries such as ureteroscopic procedures and complex pelvic laparoscopy [6,7]. …”

Section: Introductionmentioning

confidence: 99%

“…Short distal ureteric defects can be managed by laparoscopic ureteroneocystostomy [4,7]. Recently, surgeons have proposed several modifications for laparoscopic ureteroneocystostomy so as to shorten the operation time and reduce the complexity of this operation [9,10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Ureteral Reimplantation underneath Broad Ligament Tunnel for Female Vesicoureteral Stenosis: A Technical Innovation

Zeng²,

Zhang³

et al. 2014

Urol Int

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Introduction: In order to anatomically reconstruct ureteral stenosis, we present a novel technique for laparoscopic ureteral reimplantation. Patients and Methods: Three young females, who were diagnosed with hydroureteronephrosis caused by congenital vesicoureteral junction obstruction, were treated by laparoscopic ureteral reimplantation with a tunnel underneath the broad ligament. Results: Surgery was performed successfully without conversion to open surgery. No major intra- or postoperative complications occurred. Postoperative follow-up was 38, 33 and 26 months, respectively. The operative time was between 220 and 260 min. The mean estimated blood loss was less than 20 ml. Subsequent imaging performed 3 months after surgery revealed relief of hydroureteronephrosis for all patients. The patients all gave birth to healthy neonates and showed normal urinary tract sonogram and urine analysis during the gestation period. Conclusion: Laparoscopic ureteral reimplantation with broad ligament tunnel is safe and effective, allowing for anatomical reconstruction of ureter defects. However, a larger clinical sample and longer follow-up period will be needed.

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Laparoscopic Ureteral Reimplantation: Technique and Outcomes

Abstract: According to intermediate followup data laparoscopic ureteral reimplantation can be performed with an excellent success rate and low morbidity. Our data substantiate this technique as an effective method for managing distal ureteral stricture.

Cited by 41 publications

References 15 publications

Laparoscopic reconstruction of iatrogenic-induced lower ureteric strictures: Does timing of repair influence the outcome?

Laparoscopic reconstruction of iatrogenic-induced lower ureteric strictures: Does timing of repair influence the outcome?

Simplified laparoscopic technique for the treatment of long distal ureteral stenosis.

Laparoscopic Ureteral Reimplantation underneath Broad Ligament Tunnel for Female Vesicoureteral Stenosis: A Technical Innovation

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