Laparoscopy-Assisted Cutaneous Ureterostomy in Children: Early Experience

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Urinary Diversion

Background:

• Temporary urinary diversion is crucial in specific pediatric urological conditions.
• Laparoscopy-assisted cutaneous ureterostomy (LA-CU) presents a minimally invasive surgical approach.

Purpose of the Study:

• To describe the technique, feasibility, and outcomes of LA-CU in pediatric patients.
• To evaluate the potential advantages of LA-CU for temporary urinary diversion.

Main Methods:

• Retrospective review of 12 children undergoing LA-CU between October 2014 and February 2017.
• Utilized a transperitoneal laparoscopic approach with trocar placement for ureter mobilization and exteriorization.
• Included both end and refluxing ureterostomies, assessing renal function and growth postoperatively.

Main Results:

• Twelve children (3 end, 9 refluxing ureterostomies) underwent LA-CU with a mean age of 18.75 months.
• Mean operative time was 94.44 minutes; follow-up ranged from 10 to 38 months.
• No major postoperative complications were observed, with improvements in renal function and growth noted.

Conclusions:

• LA-CU is a feasible and safe technique for temporary urinary diversion in select pediatric urological cases.
• Laparoscopic assistance provides enhanced visualization, accurate ureter identification, and mobilization, optimizing drainage.
• Minimally invasive approach with single trocar at stoma site reduces scarring.