[Laparoendoscopic single site (LESS) ureteral reimplantation.]

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Ureteral stenosis can result from various conditions including endometriosis, ureteroceles, and iatrogenic injuries.
• Traditional surgical approaches may involve significant morbidity and longer recovery times.

Purpose of the Study:

• To detail the surgical technique of transumbilical Laparoendoscopic Single-Site (LESS) ureteral reimplantation.
• To evaluate the initial clinical experience and outcomes of LESS ureteral reimplantation for treating ureteral stenosis.

Main Methods:

• Seven patients underwent transumbilical LESS ureteral reimplantation using a multichannel platform and a 3.5 mm accessory trocar.
• Etiologies included endometriosis, ureterocele, post-ureteroscopy injury, post-prostatectomy injury, and gynecologic iatrogenic injuries.
• Preoperative urinary diversions were utilized as needed, with intraoperative catheterization attempted when feasible.

Main Results:

• Mean patient age was 49.3 years; mean operative time was 127.4 minutes with no conversions to open surgery.
• Mean estimated blood loss was 132.1 ml, with no transfusions required; mean hospital stay was 2.1 days.
• A single minor complication (urinary tract infection) was observed; no recurrence of ureteral stenosis was noted during a mean follow-up of 32.6 months.

Conclusions:

• Transumbilical LESS ureteral reimplantation is a feasible and safe technique with a low complication rate.
• The approach offers advantages such as reduced postoperative pain, minimal abdominal wall trauma, and improved cosmetic results.
• Patients experience rapid recovery and a quick return to daily activities.