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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Laparoscopic ureteroneocystostomy: modification of current techniques.

Jae Hyun Ahn1, Ji-Yeon Han, Jong Kil Nam

  • 1Department of Urology, Pusan National University Hospital, Busan, Korea.

Korean Journal of Urology
|January 31, 2013
PubMed
Summary

Laparoscopic ureteroneocystostomy with extracorporeal eversion is a feasible technique for treating distal ureteral lesions. This minimally invasive approach demonstrated high success rates and no major complications in a small patient cohort.

Keywords:
Gynecologic surgical proceduresLaparoscopyUreterWounds and injuries

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Distal ureteral strictures and obstructions can arise from various causes, including gynecological surgeries and cancer.
  • Traditional open surgical techniques for ureteroneocystostomy can be associated with significant morbidity.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of laparoscopic ureteroneocystostomy with extracorporeal eversion of the ureteral end for distal ureteral lesions.
  • To assess the safety and efficacy of this minimally invasive technique.

Main Methods:

  • Retrospective review of 5 laparoscopic ureteroneocystostomy procedures.
  • Patients presented with distal ureter stricture/obstruction (n=4) or low-grade distal ureter cancer (n=1).
  • Procedure involved cystoscopic ureteral stenting and extracorporeal eversion of the ureter via a 10-mm port.

Main Results:

  • Successful laparoscopic ureteral reimplantation in all 5 patients.
  • Mean operative time was 137 minutes; 2 patients required an additional psoas hitch.
  • Short-term success confirmed by imaging at 3 months; mean follow-up of 12 months with no major complications.

Conclusions:

  • Laparoscopic ureteroneocystostomy with extracorporeal eversion is a viable option for benign and malignant distal ureteral strictures.
  • Technical modifications, including nonreflux anastomosis and simultaneous cystoscopy, enhance procedural ease and success.
  • Surgeons should be proficient in various techniques for optimal patient outcomes.