Laparoscopic ureteral reimplantation in surgical lesions of the lower ureter

Abstract

  Introduction: There are different ways of treating surgical lesions of the left lower ureter (LU), which include open and minimal invasive surgeries: endourologic and laparoscopic procedures. The latter was introduced in Cuba for the first time at National Center of Minimal Invasive Surgery (NCMIS). Objectives: To describe the outcome of laparoscopic ureteral reimplantation (LUR) in the treatment of LU injuries, at the NCMIS. Methods: 19 patients with a diagnosis of LUI were selected, based on inclusion criteria, were assisted in the Urology Department at the NCMIS and were treated with direct extravesical transperitoneal LUR without anti-reflux technique, between January 2003 and December 2009. A descriptive, prospective study was carried out. Results: The average age of the patients studied was 38.9 years and females prevailed. Gynecological surgery was the main cause of the lesions repaired with this technique. LUR was feasible in 94.7 % of patients. One patient required conversion to open surgery. Average operative time was 234 minutes and transoperative bleeding was minimal. There were no transoperative complications, and two patients (10.6 %) had postoperative complications related to urinary infections, due to different causes. Average hospital stay was 4.4 days, with a rapid comeback to social life. The surgical technique was successful in all cases. Conclusions: Laparoscopic ureteral reimplantation is a feasible and successful alternative treatment for surgical lesions of the lower ureter.

Key words: ureteral reimplantation, ureteral lesions, iatrogenic, laparoscopic surgery.