V11-10 Mini Laparoscopic Pyeloplasty of a Retrocaval Ureter

Abstract

21 cases, transperitoneal approach plus retroperitoneal balloon dilation in 2, and retroperitoneal approach in 1. The median operative time and blood loss were 206 minutes (range, 73-513) and 10 mL (range, 0-1,020), respectively. No patient required blood transfusion or conversion to open surgery. Pathological examination revealed paraganglioma in 11, ganglioneuroma in 7, and schwannoma in 6. At the last follow-up, 22 patients were free of disease, while one patient developed metastatic recurrence of paraganglioma. A review of the records revealed several tips, including taping the vena cava/ renal vein (n¼2) for tumor dissection or rotating the kidney to approach the tumor behind renal hilum (n¼2). In several cases, 3D-CT was helpful for preoperative planning.CONCLUSIONS: Laparoscopic resection of paraaortic or paracaval neurogenic tumors is feasible. Surgeons should be familiar with dissection around great vessels and the mobilization of adjacent organs. Careful preoperative planning, including 3D-CT, is important.