Pure transperitoneal laparoscopic correction of retrocaval ureter

Area of Science:

• Urology
• Minimally Invasive Surgery
• Congenital Abnormalities

Background:

• Retrocaval ureter is a rare congenital anomaly requiring surgical intervention for significant obstruction.
• Laparoscopic approaches are preferred for minimally invasive treatment but can be technically demanding.
• This study details techniques for pure transperitoneal laparoscopic repair.

Purpose of the Study:

• To present surgical techniques and outcomes of pure transperitoneal laparoscopic pyelopyelostomy and ureteroureterostomy for retrocaval ureter.
• To evaluate the feasibility and efficacy of this laparoscopic approach in a cohort of patients.

Main Methods:

• Nine patients with retrocaval ureter underwent laparoscopic pyelopyelostomy or ureteroureterostomy via a three-port transperitoneal approach.
• Key steps included ureter relocation anterior to the inferior vena cava and tension-free anastomosis using intracorporeal suturing.
• Antegrade double J stent insertion and postoperative imaging were performed.

Main Results:

• All nine operations were successfully completed laparoscopically without conversion to open surgery.
• Mean operative time was 135 minutes with minimal blood loss (<60 ml) and no intra-operative complications.
• Patients experienced mild postoperative pain, rapid recovery, symptom resolution, and significant hydronephrosis reduction.

Conclusions:

• Pure transperitoneal laparoscopic correction for retrocaval ureter demonstrates excellent outcomes, minimal invasiveness, and short hospital stays.
• The technique is technically feasible and reliable for treating retrocaval ureter.
• Laparoscopic surgery is proposed as a standard treatment option for this condition.