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      Laparoscopic Dismembered Repair in Two Patients with Retrocaval Ureter

      case-report

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          Abstract

          Retrocaval ureter (RCU) or circumcaval ureter is a rare cause of congenital hydronephrosis. The surgical correction of RCU should be performed in all patients with obstruction and hydronephrosis symptoms, lumbar pain, urinary tract infections, hematuria, or urolithiasis. Traditionally, an open surgical approach was used for the treatment of RCU. Nowadays, surgical correction of these anomalies is performed using minimally invasive techniques. We report on two cases treated with our standardized laparoscopic technique using only three 5-mm trocars. The proposed approach could be considered as the first-line treatment for RCU.

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          Most cited references15

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          Laparoscopic surgical correction of circumcaval ureter.

          M Oya, N Deguchi, S. Baba … (1994)
          Laparoscopic transposition and reanastomosis of a circumcaval ureter were performed in a 52-year-old man with right flank pain. A preoperative perfusion pressure study revealed abnormally high intrapelvic pressure. Under laparoscopy, the renal pelvis was divided above the ureteropelvic junction and the ureter was relocated from behind the vena cava. A 5 cm segment of redundant ureter containing the postcaval segment was resected and the ureteral end and renal pelvis were reapproximated with interrupted sutures by intracorporeal knot typing. The postoperative convalescence was uneventful, not necessitating the administration of analgesics. The patient resumed full activities 3 weeks later. The intravenous urogram and renogram obtained 2 months after the operation revealed remarkable improvement in the ureteral obstruction.
          Article 0 comments Cited 16 times – based on 0 reviews     Review now
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            Laparoscopic pyelopyelostomy for retrocaval ureter without excision of the retrocaval segment: first report of 6 cases.

            N. Simforoosh, K Nouri-Mahdavi, A Tabibi (2006)
            We report our series of 6 cases of retrocaval ureter that were successfully treated with a laparoscopic approach. Three men and 3 women with a mean age of 31 years (range 16 to 50) were referred to our department with a diagnosis of retrocaval ureter. One patient had a 12 mm renal pelvic calculus. A transperitoneal laparoscopic approach was used in all cases. The retrocaval segment along with some of the more proximal and distal segments of the ureter was readily mobilized. The distal part of the dilated renal pelvis was transected and the divided distal segment was repositioned to lie anterior to the inferior vena cava. The renal pelvic stone in 1 patient was readily removed at this point. Re-anastomosis was then performed over a Double-J stent placed intraoperatively using 2 rows of running 4-zero polyglactin sutures with intracorporeal knot tying. The stent was removed 4 weeks later. Excretory urography was performed 3 months after the laparoscopic procedure. Mean operative duration was 180 minutes (range 150 to 210). Patients were discharged home at a mean of 4 days (range 3 to 5). Followup excretory urogram 3 months after laparoscopic repair revealed a widely patent anastomosis with considerable improvement in hydronephrosis in all patients. To our knowledge this is the largest series of laparoscopic repair of retrocaval ureter reported to date. Laparoscopic pyelopyelostomy for retrocaval ureter without excision of the retrocaval segment is associated with an excellent outcome, minimal postoperative morbidity, short hospital stay and highly satisfactory cosmetic results.
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              Pure transperitoneal laparoscopic correction of retrocaval ureter.

              Xin-de Li, Gong-Hui Li, Guo-qing Ding … (2012)
              Retrocaval ureter is a rare congenital abnormality. Operative repair is always suggested in cases of significant functional obstruction. Laparoscopic procedures have been employed as the minimally invasive therapeutic option for retrocaval ureter. However, the laparoscopic techniques for retrocaval ureter might be technically challenging to some surgeons. The aim of this article was to present our experience and surgical techniques of pure transperitoneal laparoscopic pyelopyelostomy and ureteroureterostomy in nine patients with retrocaval ureter.
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                Author and article information

                Journal
                Journal ID (nlm-ta): European J Pediatr Surg Rep
                Journal ID (iso-abbrev): European J Pediatr Surg Rep
                Journal ID (doi): 10.1055/s-00024358
                Title: European Journal of Pediatric Surgery Reports
                Publisher: Georg Thieme Verlag KG (Stuttgart · New York )
                ISSN (Print): 2194-7619
                ISSN (Electronic): 2194-7627
                Publication date (Print): January 2020
                Publication date (Electronic): 23 April 2020
                Volume: 8
                Issue: 1
                Pages: e32-e34
                Affiliations
                [1 ]Department of Surgery, Urology UOSD, University of Rome Tor Vergata, Roma, Lazio, Italy
                [2 ]Department of Nephrology and Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
                [3 ]Division of Pediatric Urology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
                Author notes
                Address for correspondence Paolo Caione, MD Division of Pediatric Urology Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio, 4 Rome 00165Italy pcaione@ 123456yahoo.it
                Article
                Publisher ID: 19505cr
                DOI: 10.1055/s-0040-1705156
                PMC ID: 7180074
                PubMed ID: 32550123
                SO-VID: 81507752-d737-49dd-bb5d-d7d5c114797a
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 May 2019
                Date accepted : 10 January 2020
                Categories
                Subject: Case Report

                Keywords: retrocaval ureter,ureteroureterostomy,laparoscopy
                Data availability:
                Keywords: retrocaval ureter, ureteroureterostomy, laparoscopy

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