Laparoscopic Ureterocalicostomy Technique

ABSTRACT

Purpose:

Ureterocalicostomy is a technique that was first described by Neuwirt in 1948 (¹) The laparoscopic access was initiated in 2003 by Cherullo et al. (²), following the established principles of open surgery. In 2004, Gill et al. had two patients with UPJO treated with laparoscopic ureterocalicostomy, with success (³). In 2014, Arap et. al. presented a case series with good results in adults and children in our service (⁴). There are factors that prepare the surgeon for an ureterocalicostomy, such as the renal cortex thickness, although the decision is mainly taken during the procedure (⁵).

Material and Methods:

A 24 years-old female patient with right lumbar pain was referred to our institution. She already had a right open pyeloplasty two years ago. The CT scan presented a right hydronephrotic kidney, DMSA scan with 30% of relative function and a DTPA scan with an obstructive pattern.

Results:

A laparoscopic ureterocalicostomy was performed due to the intra-operative findings (inferior kidney pole thickness and challenging access to the uretero-pelvic junction). The overall time was 130 minutes with no complications. The patient was discharged in two days and the double J was withdrawn in four weeks. The CT scan within one year demonstrates a reduction of the hydronephrosis. She had no more lumbar pain.

Conclusion:

In complex cases, the laparoscopic ureterocalicostomy proves to be a safe and efficient procedure, with a free tension-free anastomosis and the advantages of the laparoscopic access.

• Available at: http://www.intbrazjurol.com.br/video-section/20220521_nunes_et_al Int Braz J Urol. 2023; 49 (Video #8): 517-8

REFERENCES

• ¹
  Neuwirt K. Implantation of the ureter into the lower calyx of the renal pelvis. Urol Cutaneous Rev. 1948;52:351.
• ²
  Cherullo EE, Gill IS, Ponsky LE, Banks KL, Desai MM, Kaouk JH, et al. Laparoscopic ureterocalicostomy: a feasibility study. J Urol. 2003;169:2360-4.
• ³
  Gill IS, Cherullo EE, Steinberg A, Desai MM, Abreu SC, Ng C, et al. Laparoscopic ureterocalicostomy: initial experience. J Urol. 2004;171:1227-30.
• ⁴
  Arap MA, Andrade H, Torricelli FC, Denes FT, Mitre AI, Duarte RJ, et al. Laparoscopic ureterocalicostomy for complicated upper urinary tract obstruction: mid-term follow-up. Int Urol Nephrol. 2014;46:865-9.
• ⁵
  Srivastava D, Sureka SK, Yadav P, Bansal A, Gupta S, Kapoor R, et al. Ureterocalicostomy for Reconstruction of Complicated Ureteropelvic Junction Obstruction in Adults: Long-Term Outcome and Factors Predicting Failure in a Contemporary Cohort. J Urol. 2017;198:1374-8.

Publication Dates

• Publication in this collection
  14 Aug 2023
• Date of issue
  Jul-Aug 2023

History

• Received
  17 Oct 2022
• Accepted
  19 Jan 2023
• Published
  31 Mar 2023