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Laparoscopic ureteroneocystostomy with psoas hitch
Shailesh Puntambekar1, Reshma J Palep, Ajit M Gurjar
1Galaxy Laparoscopy Institute Pune, Maharahstra, India.
Journal of Minimally Invasive Gynecology
|July 11, 2006
Summary
This study shows laparoscopic extravesical ureteroneocystostomy with freehand suturing is a viable option for treating ureterovaginal fistulas after gynecologic surgery, avoiding open procedures.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Gynecologic Oncology
Background:
- Ureterovaginal fistulas are a rare but serious complication after laparoscopic hysterectomy.
- Laparoscopic extravesical ureteroneocystostomy is an infrequently described technique for managing such fistulas.
Purpose of the Study:
- To describe the successful application of intracorporeal freehand suturing for laparoscopic extravesical transperitoneal ureteral reimplantation with psoas hitch.
- To report the preliminary outcomes of this technique in five female patients.
Main Methods:
- Five female patients underwent laparoscopic extravesical ureteroneocystostomy with psoas hitch.
- Indications included ureterovaginal fistulas post-total laparoscopic hysterectomy and post-laparoscopic radical hysterectomy.
Main Results:
- Average surgical time was 220 minutes with 150 mL blood loss.
- Patients experienced short hospital stays (3 days) and rapid oral intake resumption (12 hours).
- No intraoperative or postoperative complications were observed; follow-up showed good renal clearance and no reflux.
Conclusions:
- Laparoscopic extravesical ureteroneocystostomy with intracorporeal freehand suturing and psoas hitch is a feasible and effective treatment for female ureterovaginal fistulas.
- This minimally invasive approach avoids open surgery, reduces patient morbidity, and offers successful repair.