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Laparoscopy-assisted ureterostomy- technique.

M Asimakidou1, G De Win2, A Cherian1

  • 1Dept of Paediatric Urology, Great Ormond Street Hospital for Children, UK.

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|June 22, 2019
PubMed
Summary
This summary is machine-generated.

This study introduces laparoscopy-assisted ureterostomy, a minimally invasive technique for urinary diversion in children. The procedure is quick, effective, and shows promising early results for managing complex urinary tract anomalies.

Keywords:
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Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Surgery
  • Urology

Background:

  • Urinary tract anomalies in children often necessitate immediate urinary diversion.
  • Open cutaneous ureterostomy is a standard but invasive approach.
  • A less invasive alternative is needed for these challenging pediatric cases.

Purpose of the Study:

  • To describe and evaluate the feasibility of a laparoscopy-assisted cutaneous ureterostomy.
  • To present early outcomes of this minimally invasive technique in pediatric patients.

Main Methods:

  • Transperitoneal laparoscopy was performed using three ports, with one working instrument inserted through the ureterostomy site to minimize scarring.
  • Laparoscopic identification, mobilization, and excision of the dilated ureter were conducted.
  • The ureteric loop was exteriorized to fashion the ureterostomy, with proximal and distal patency confirmed.

Main Results:

  • Nineteen pediatric patients underwent the procedure for various conditions including VUR, neuropathic bladder, and posterior urethral valves.
  • The mean operative time was 40 minutes, with patients discharged within 72 hours.
  • At three months, clinical and ultrasound reviews indicated stable upper tracts and no urinary tract infections (UTIs).

Conclusions:

  • Laparoscopy-assisted ureterostomy is a quick and feasible technique, even in neonates.
  • It allows for precise dissection and tensionless ureter exteriorization, ensuring prompt drainage.
  • This approach offers potential benefits over traditional open surgery for pediatric urinary diversion.