Single trocar retroperitoneoscopic assisted ipsilateral ureteroureterostomy for ureteral duplication

Abstract

The aim of this study is to present the technique and early outcomes of single trocar retroperitoneoscopic assisted ureteroureterostomy for ureteral duplication. The patient was placed in a lateral decubitus position. A skin incision of 11 mm width was made above the iliac crest. The operation was performed through single trocar with operating laparoscope. The two ureters were encircled with a vessel loop and exteriorized outside the retroperitoneal space via trocar incision. The pathologic ureter was divided as low as possible. The recipient ureter was opened longitudinally. End-to-side ureteroureterostomy anastomosis was performed extracorporeally with two running 6/0 PDS sutures. From December 2010 to July 2011, nine patients were operated on using the same technique. Patient's ages ranged from 2 to 72 months. Mean operative time was 78 ± 21 min. There were no intra or postoperative complications. Postoperative stay was 2.6 ± 1.0 days. Follow-up revealed that two renal moieties preserved their functions in all patients. The diameter of involved ureters and pelvises was significantly reduced in all patients. Single trocar retroperitoneoscopic assisted ureteroureterostomy is safe and effective procedure for ureteral duplication.

Laparoscopic-Assisted Ureteroureterostomy for Duplication Anomalies in Children

“…[1][2][3] Multiple authors have also reported the technique and results of minimally invasive approaches to ureteroureterostomy including laparoscopic, single site, and robot-assisted approaches for the repair of proximal and distal obstruction in the duplicated system, midureteral pathology, as well as for the management of reflux and ectopic ureters in a duplicated system. [5][6][7][8][9][10][11][12][13][14] A summary of the existing literature on laparoscopic and robotic ureteroureterostomy in children is provided in Table 2. A pooled analysis of all results reveals a mean operative time of 182 minutes (78-244 min) and a mean length of stay of 2.8 days (1-9 d).…”

“…In addition, our operative time included stent placement while the fastest reported operative time reported in the literature (78 min) was without ureteral stent placement. 10 The performing surgeon recorded his own time to secure the ureter during the laparoscopic-assisted ureteroureterostomy procedure, which averaged 10 minutes (6-15). In addition, 6/9 (67%) of patients in the laparoscopic-assisted group went home the day of surgery and the remaining three spent one night in the hospital.…”

Surgical treatment of ureterocele and ectopic ureters

“…Operasyonu laparoskopik ya da robot yardımlı olarak üreterlerin distalinde de gerçekleştirmek olasıdır (22,23,24,27) . Ameliyatın anastomoz kısımlarının batın dışında gerçekleştirildiği laparoskopi yardımlı ve retroperitoneoskopi yardımlı şekilleri de tanım-lanmıştır (30,31) .…”