V11-10: Mini Laparoscopic Pyeloplasty of a Retrocaval Ureter
VideoIntroductions and Objectives
Mini laparoscopy is an emerging field of minimally invasive surgery that involves the use of 2mm, 3mm and 5mm laparoscopic instruments. This approach causes less abdominal trauma and, consequently, minimizes pain and surgical stress, as well as providing an excellent aesthetic result. Retrocaval ureter is a congenital anomaly, and its golden standard treatment is the laparoscopic pyeloplasty. The aim of this video is to demonstrate a case of a retrocaval ureter approached by mini laparoscopy.
A 23-year old male patient was presented with recurrent right flank pain; the CT scan demonstrated retrocaval ureter with uretero-pelvic junction (UPJ) obstruction.
A double J catheter was placed endoscopically; after that, a 3mm trocar and two 5mm ones were used to perform the entire laparoscopic procedure. The operative time was 80 minutes, the blood loss 50ml and no external drain was used; the patient was discharged in the first post operative. The Folley catheter was removed in the second p.o. and the double J stent after six weeks. After 3 months, both ureters demonstrated satisfactory kidney bilateral contrast excretion and the patient reported no existence of right flank pain.
Conclusively, the main applications of mini laparoscopy in urology are to ureteral pathologies – mainly typical UPJ obstructions. To our knowledge, this was the first description of treatment of retrocaval ureter.