Laparoscopic ureteral injury and repair: case reviews and clinical update

Ureteral injuries are known complications of pelvic surgery. The incidence is 0.5% to 3%, and approximately one-third of these cases are not identified or corrected intraoperatively. It is critical to recognize and repair these injuries intraoperatively to decrease morbidity and prevent further complications, such as ureteral stricture, fistula formation, or loss of renal function. Traditionally, laparotomy has been the method of choice for ureteral injuries even when the injury is identified during a laparoscopic procedure. Laparoscopy has been shown to result in decreased infection rate, fewer incisional hernias, shorter hospital stay, and quicker recovery compared with laparotomy. Several articles were reviewed of successful laparoscopic ureteral injury repair, in addition to the 2 cases presented in this article. We conclude that laparoscopic ureteral injury repair is feasible, safe, and effective.