Laparoscopic renal descensus for upper tract reconstruction

We describe a modern use of laparoscopic renal descensus during the reconstruction of the upper urinary tract. The patient is a 76-year-old mononephric man with recurrent carcinoma in situ in the distal ureter. Using the described technique, we produced an additional 8 to 10 cm of ureteral length and performed a simple ureteroneocystotomy instead of using a traditional psoas hitch and Boari flap creation, bowel interposition, or autotransplantation. Laparoscopic renal descensus is an uncommonly used but simple procedure that may prevent the need for bladder mobilization or Boari flap creation, particularly in the setting of a hostile pelvis.