We report our experience in the laparoscopic transperitoneal repair of retrocaval ureter in two cases, highlighting a new technique of stenting.

Open pyeloplasty is the gold standard in the treatment of congenital ureteropelvic junction obstruction. Several reports have shown that laparoscopic pyeloplasty produces comparable results. In this paper, we report a retrospective study of the transmesocolic approach to the left ureteropelvic junction obstruction in 26 patients. As colon mobilization is avoided, the field remains fairly clear. This direct approach also saves time and is least invasive. One patient was lost for follow-up, and 1 patient is awaiting a renogram. Among the remaining 24 patients, 22 patients had improved drainage (IVU or isotope renogram), and 2 of the patients had stable renal function.

With increasing experience in laparoscopic reconstructive urologic procedures, laparoscopic pyeloureterostomy is a feasible option, even in infants.

Background:Laparoscopic pyeloplasty is one of the most common reconstructive procedures performed by urologists. Both continuous and interrupted sutures are being practiced for ureteropelvic anastomosis. The success rate and the complications associated with the suturing technique needs evaluation. We analyzed the results from of our patients who underwent laparoscopic pyeloplasty using both techniques.Objective:To review the outcome differences among patients undergoing laparoscopic pyeloplasty regarding suturing technique.Materials and Methods:All patients who underwent laparoscopic, transperitoneal dismembered pyeloplasty of the primary pelviureteric obstruction were analyzed. The primary outcome was successful pyeloplasty, as assessed by the resolution of symptoms and T½ <10 minutes. The secondary outcomes were the complication rate and the operative parameters. The difference in the parameters was assessed by Student t test analysis.Results:Of the 107 patients we studied, 65 had interrupted suturing and 42 had continuous suturing. The success rate was not significantly different among the 2 groups. The mean suturing time, postoperative drainage volume, postoperative hospital stay, and total cost of the procedure were significantly less in the continuous suturing group.Conclusion:The continuous suturing technique is preferred over the interrupted suturing technique for laparoscopic pyeloplasty because the success rates are equal and the postoperative stay, suturing time, drain output, and cost of the procedure are better.

We report the technique of laparoscopic repair of vesicouterine fistula. A 30 year old lady presented with incapacitating cyclical pain for one and a half years. She had undergone cesarean section 18 months ago. She was evaluated by a CT scan of abdomen and pelvis followed by a cystoscopy and diagnosed to have a vesicouterine fistula. This was managed laparoscopically (laparoscopic disconnection of fistula; closure of bladder and uterine rent; and omental interposition). There were no intraoperative or postoperative complications. Follow up CT scan of abdomen and cystoscopy revealed good healing of the repaired area. Laparoscopic repair of vesicouterine fistula is a feasible procedure.