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Updated: Jan 10, 2026

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Published on: November 22, 2019

Single-position intraperitoneal laparoscopic radical nephroureterectomy using a modified supine position.

Xiaomin Han^1,2, Menghao Zhou², Ming Xiong¹

¹Department of Urology, Medical School, South China Hospital, Shenzhen University, Shenzhen, 518116, China.

|November 25, 2025

Summary

A novel single-position laparoscopic surgery for upper tract urothelial carcinoma (UTUC) offers efficient workflow and safe radical nephroureterectomy (RNU) with bladder cuff excision (BCE). This technique allows direct visualization and reproducible results without patient repositioning.

Keywords:

Bladder cuff excision (BCE)Intraperitoneal laparoscopy Radical nephroureterectomy (RNU)Single-position Supine position Upper tract urothelial carcinoma (UTUC)

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Area of Science:

Urology
Surgical Oncology
Minimally Invasive Surgery

Background:

Upper tract urothelial carcinoma (UTUC) requires radical nephroureterectomy (RNU) and bladder cuff excision (BCE).
Traditional methods may involve patient repositioning, increasing operative time and complexity.
Laparoscopic approaches aim to improve outcomes and reduce invasiveness.

Purpose of the Study:

To introduce and evaluate a novel single-position intraperitoneal laparoscopic surgery (SP-ILS) technique.
To assess the feasibility and safety of SP-ILS for RNU and BCE in the supine position.
To demonstrate the efficiency of a single-position workflow for UTUC treatment.

Main Methods:

Retrospective analysis of 40 patients with UTUC undergoing SP-ILS for RNU and BCE.
Procedures performed between January 2019 and June 2023.
Data collected included clinical, perioperative, and pathological information.

Main Results:

All 40 procedures were completed laparoscopically without patient repositioning.
No intraoperative or postoperative complications were reported.
Mean operative time was 101 minutes, with minimal blood loss (53 mL) and a short hospital stay (4.2 days).
Pathology revealed stages Ta, T1, and T2 UTUC.
One bladder recurrence occurred during a mean follow-up of 12.9 months.

Conclusions:

The SP-ILS technique provides direct visualization for RNU and BCE.
It enables a reproducible and efficient single-position workflow.
This approach is a safe and effective option for managing UTUC.