Laparoscopy-Assisted Extracorporeal Ureteral Anastomosis : a New Technique

Lee, Ahnkie; Jung, Byong Chang; Lee, Kyeong Cheol; Yun, Sang Jin; Oh, Seung June; Park, Moon Soo; Choi, Hwang

Abstract

We investigated the feasibility of the extracorporeal suture technique in laparoscopic pyeloplasty and laparoscopic ipsilateral ureteroureterostomy in child with ureteropelvic junction obstruction or duplex kidney. Laparoscopic pyeloplasty and laparoscopic ureteroureterostomy were performed in a child with ureteropelvic junction obstruction and in a 3-year old child with duplex kidney, respectively. Ureteropelvic junction or ureters were dissected laparoscopically and were drawn out of the abdominal cavity through the 10mm trocar tracts and subsequently anastomosed extracorporeally. We were able to draw the ureteropelvic junction or the ureters out of the abdominal cavity without difficulty owing to the laxity and thin abdominal wall in children. Operating time was 120 minutes in both cases, and all anastomses between ureter and pelvis were completed without any intraoperative complication. There was no postoperative complication. Significant improvements in urinary drainage were shown in both children on postoperative intravenous pyelogram. These early results suggest that the extracorporeal suture technique in children is feasible and easy to perform. Therefore, the drawbacks of intracorporeal suture technique during the laparoscopic pyeloplasy or ureteroureterostomy could be overcome by using this novel teehnique.