Laparoscopic ureteral reimplantation: technique and outcomes.
ABSTRACT We describe our experience with laparoscopic ureteral reimplantation in 45 adults, and report success rates and complications at intermediate term followup.
We performed a retrospective chart review of 45 patients who underwent laparoscopic ureteral reimplantation between 1997 and 2007. Demographics, clinicopathological parameters, perioperative course, complications and followup studies were analyzed.
Elective laparoscopic ureteral reimplantation was performed in 35 female and 10 male patients with a mean followup of 24.1 months (range 1 to 76). All patients presented with distal ureteral stricture with a mean stricture length of 3 cm and a mean +/- SD preoperative serum creatinine of 0.91 +/- 0.04 mg/dl. Mean patient age was 47.8 +/- 2.2 years (range 17 to 87). Mean American Society of Anesthesiologists score was 2 (range 1 to 3). Median estimated blood loss was 150 ml. The overall success rate, defined as radiographic evidence of no residual obstruction, symptoms, renal deterioration or need for subsequent procedures, was 96%. Two patients had recurrent strictures and 1 underwent nephrectomy for flank pain and preexisting chronic pyelonephritis.
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.
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ABSTRACT: Laparoscopic Boari flap reimplantation has been used to treat long distal ureteral strictures. This technique requires extensive bladder mobilization and complex intracorporeal suturing. This demonstrates a novel laparoscopic bladder dome advancement approach for ureteral reimplantation. This technique obviates the need for bladder pedicle dissection and simplifies the required suturing.Urology 01/2006; 66(6):1307-9. · 2.42 Impact Factor
Article: Laparoscopic ureteroneocystostomy.[show abstract] [hide abstract]
ABSTRACT: The technique of laparoscopic ureteral reimplantation is reported and discussed. This approach represents another surgical procedure that may be performed by the less invasive laparoscopic method.The Journal of Urology 01/1995; 152(6 Pt 1):2057-9. · 3.70 Impact Factor
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ABSTRACT: Major advances have been made in the area of laparoscopic surgery. The advantages of this approach include smaller incisions, shorter hospitalizations, a more rapid convalescence and decreased postoperative discomfort. To explore the technical feasibility of performing antireflux surgery laparoscopically, we conducted a pilot study in 4 mini-pigs in which bilateral vesicoureteral reflux had been created surgically. We applied a modification of the Lich extravesical ureteral approach to perform laparoscopic antireflux surgery. All mini-pigs underwent successful unilateral mobilization, creation of a bladder wall trough and creation of a new ureteral tunnel laparoscopically. Examinations were performed postoperatively, and then serially at 1, 2, 3 and 5 months after repair. Fluoroscopic cystograms demonstrated the resolution of reflux in the corrected ureters and persistence of reflux in the uncorrected control ureters in all animals. Excretory urography showed no evidence of obstruction. Laparoscopic correction of vesicoureteral reflux appears to be technically feasible in the animal model. Long-term followup is necessary to determine the possible applicability of this technique in humans.The Journal of Urology 09/1993; 150(2 Pt 2):748-51. · 3.70 Impact Factor