Lighted ureteral stents in laparoscopic colorectal surgery; a five-year experience

Abstract

Background: Ureteral injuries during colorectal surgery are a rare event, ranging in the literature from 0.28-7.6%. Debate surrounds the use of prophylactic lighted ureteral stents to help protect the ureter during laparoscopic surgery. It has been suggested that they help to identify injuries but do not prevent them. The authors look to challenge this.Methods: Over 66 months, every laparoscopic or colectomy involving ureteral stents was recorded. Researchers documented any injury to the ureter intraoperatively. The chart was also reviewed for the complications of urinary tract infection (UTI) and urinary retention post-operatively.Results: During the 66 months, 402 laparoscopic colon resections were done. There were no ureteral injuries.The lighted ureteral stent was identified during every case in the effort to prevent injury during dissection and resection. No catheter associated UTIs were identified, while 14 (3.5%) suffered from post-operative urinary retention. Conclusions:The authors of this study present a large series of colon resections with no intraoperative ureteral injuries. In addition, these catheters were not associated with any UTIs and a rate of urinary retention similar to that of the at large data. This series provides compelling data to use lighted ureteral stents during laparoscopic colon surgery.

Feasibility of Using an Led-Probe in Third-Space Endoscopy: A Clinical Study

“…The use of lighting devices has been explored in medicine for years. In colorectal and gynecological surgeries, for example, iatrogenic ureteric injury is a serious complication with a variable incidence between 0.7-10% [14]. The identification of ureters is challenging and the optional double J stent placement is invasive and associated with serious adverse events [15];however, the use of fluorescence and lighted ureteral stents has overcome these problems.…”

Ureteral Injury During Colorectal Surgery: Two Case Reports and a Literature Review

“…The authors concluded that prophylactic LUS placement in laparoscopic colectomy is a safe procedure. Boyan et al 15) reported a total of 465 laparoscopic colorectal resections with prophylactic LUS. No IUI occurred.…”

“…It was also advocated that LUS insertion might save time in the operating room by simplifying the ureter identification procedure and, in cases of injury, avoiding complex interventions. Considering the operative time required for injury identification and repair, the LUS insertion procedure itself is time-effective, requiring approximately 11-28 min, depending on the length of the procedure and coordination arrangements 6,14,15) .…”

Feasibility of Using an LED-Probe in Third-Space Endoscopy: A Clinical Study

“…Lighting devices for surgical guidance have been investigated for years with good results. In laparoscopic colorectal and gynecological surgeries, the use of lighted ureteral stents successfully prevented iatrogenic injuries [14,15]. In ophthalmologic procedures, light-emitting diode (LED) technology is used for vitrectomy, with the advantage of no thermal or photodynamical harm; this provides better illumination than other light sources [16,17].…”