OBJECTIVE: To describe a new surgical technique of the first case of totally laparoscopic repair of primary obstructive congenital megaureter with pyeloplasty, intracorporeal excisional tailoring of the ureter and nonrefluxing ureteroneocystostomy.
METHODS: A 15-year-old male presented with obstructive megaureter. The standard three-port transperitoneal pyeloplasty technique and an additional 5-mm port for dynamic traction were used. Pelvic and ureteral dissection, pyeloplasty, intracorporeal excisional ureteral tailoring and nonrefluxing ureteroneocystostomy were all completed laparoscopically. A double-J stent was used to calibrate the ureter.
RESULTS: Operative time was 240min. No intra and postoperative complications were observed, and there was discharge on postoperative day 2. The patient was pain-free and without urinary tract infection during the 4-month period after surgery. Follow up revealed complete resolution of the ureteral obstruction and adequate pelvic and ureteral caliber.
CONCLUSION: Laparoscopic pyeloplasty, intracorporeal excisional tailoring, and non-refluxing reimplantation are safe and effective for the treatment of obstructive congenital megaureter. The totally laparoscopic approach is reproducible and provides low morbidity with inherent cosmetic advantages.
Written by:
Almeida GL, Busato WF, de Cobelli O. Are you the author?
Surgery Department, Laparoscopic Section, Catarinense Institut of Urology; University of Vale do Itajaí (UNIVALI), Itajaí, Brasil; Department of Urology, European Institute of Oncology (IEO), University of Milan, Milán, Italia.
Reference: Actas Urol Esp. 2013 Aug 1. pii: S0210-4806(13)00223-4.
doi: 10.1016/j.acuro.2013.04.011
PubMed Abstract
PMID: 23910727
Article in English, Spanish.
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