Abstract
Objective:
Single ectopic ureters are a rare malformation in adults. We describe the technique, feasibility, and effectiveness of laparoendoscopic single-site (LESS) intracorporeal ureteroneocystostomy with the single ectopic ureter.
Patients and Methods:
A 53-year-old woman was referred with chronic urinary tract infection. Intravenous urography and voiding cystoureterography revealed a double collecting system and incomplete double ureter of the left kidney with an ectopic ureter and vesicoureteral reflux (VUR) grade 3. No bladder overactivity was found during the urodynamic study. The patient underwent LESS ureteral reimplantation. The procedure was done transumbilical by using a single incision laparoscopic surgery (SILS) port, roticulator instruments, and standard laparoscopic intracorporeal suturing with an Endo-stitch device. Patient demographic, preoperative symptom, radiological imaging, complications, and postoperative outcomes were analyzed.
Results:
LESS ureteral reimplantation was performed in the patient. The operative time was 180 min, with an estimated blood loss of <50 mL. No immediate postoperative complications were observed. Postoperatively, orals were allowed on day 1, and drain and Foley catheter were removed on days 3 and 7, respectively. The hospital stay was 4 days. Double-J stent was removed 6 weeks after surgery. The time to return to normal activity was 2 weeks. Urinary tract infection during follow-up was not developed. Follow-up intravenous urography confirmed reduction of hydronephrosis and good drainage.
Conclusion:
LESS ureteral reimplantation is an effective procedure with good results. It is an advanced laparoscopic technique that closely resembles open and laparoscopic surgical techniques and provides a safe alternative to existing methods. We believe that this procedure will become an established treatment option.
No competing financial interests exist.
Runtime of video: 6 mins 32 secs
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