Laparoendoscopic Single-Site Ureteroureterostomy with Intraoperative Retrograde Ureteroscopy-Assisted Technique for Benign Proximal and Middle Ureteral Strictures: A Single-Center Experience

Abstract

LESS-UU is feasible and safe for repairing benign proximal and middle ureteral stricture. The intraoperative retrograde ureteroscopy-assisted technique during LESS-UU is useful for localizing the stricture.

Retrograde flexible ureteroscopy-assisted retroperitoneal laparoscopic ureteroureterostomy for refractory ureteral stricture: A case report

“…Laparoscopic UU has been reported for the treatment of benign ureteral strictures, iatrogenic injury during gynecological surgery, and retrocaval ureter [1] , [4] . UU is traditionally performed through open surgery, but it has recently been increasingly performed through several minimally invasive techniques, including laparoscopic, robot-assisted, and LESS UU [1] , [2] , [3] . The portion of the affected ureter must be completely removed surgically, although only a minimum length should be excised.…”

“…Chow et al reported an observation method using a rigid ureteroscope during laparoscopic surgery to identify a stricture [6] . Tang et al reported the use of rigid ureteroscope during LESS UU and described the availability of this instrument in developing countries; thus, this technique may have widespread applicability [3] . However, it is necessary to place the patient in the lithotomy position when using a rigid scope and if the laparoscopic procedure is combined with the lateral decubitus position, the acrobatic posture must be employed.…”

“…In ureteroureterostomy (UU), which is usually performed by laparoscopic or open surgery, the affected part of the ureter is surgically removed and reconnected to normal healthy ureteral tissue [1] . Recent reports have described UU via robotic-assisted surgery [2] and minimally invasive procedures such as laparoendoscopic single-site surgery (LESS) [3] . Laparoscopic UU requires accurate suture techniques, but it is difficult to precisely identify the location and length of a ureteral obstruction without the ability to determine tactile sensation.…”

Transabdominal Laparoscopic Ureteroureterostomy With the Intraoperative Retrograde Ureteroscopy-Assisted Technique for Multiple Ureteral Polyps: A Single-Center 10 Years Experiences

“…After endotracheal intubation following general anesthesia, patients were then passively placed in a position, which is a hyper extensive lithotomy position with the body in a 45 recumbent position on the surgical side up. The abdomen and perineum were disinfected together, and an arcuate incision of ∼2 cm was made at the umbilicus (Figure 1, point A), followed by the insertion of a Veress needle and inflation of the umbilicus with carbon dioxide to maintain the intra-abdominal pressure at 12-14 mmHg, as described by Tang et al (12). A 12 mm trocar for the laparoscope was then placed through the incision.…”

Contemporary management of ureteral strictures

“…Several authors have recommended the use of a rigid ureteroscope to confirm the length of the stricture. 56, 57 Recently, a single surgeon operative experience with robotic UU for upper, mid and distal ureteral strictures found that patients had 100% recurrence-free survival at 3 years follow-up; however, this procedure is technically limited by complex port placement. 58…”