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Intracorporeal ileal ureter replacement using laparoscopy and robotics.

Sim A, Todenhöfer T, Mischinger J, Halalsheh O, Boettge J, Rausch S, Bier S, Aufderklamm S, Stenzl A, Gakis G, Schwentner C - Cent European J Urol (2014)

Bottom Line: Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery.We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter.Numbers are still small but its application is likely to grow further.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Eberhard-Karls University, Tuebingen, Germany.

ABSTRACT

Introduction: Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery. We report our experience using minimally invasive techniques for total intracorporeal ureteral replacement.

Material and methods: A chart review revealed five patients who underwent intracorporeal ileal ureter using minimally invasive techniques in the preceding 5 years. 4 patients underwent conventional laparoscopic surgery and 1 patient underwent robotic-assisted surgery. Patient's characteristics, perioperative data and functional outcomes as well as a detailed description of surgical technique are reported. In all 5 of these patients, the ileal ureter was performed completely intracorporeally.

Results: The median age of our patients is 61 (range 42-73). The median operative time was 250 minutes (range 150-320) and median blood loss was 100 ml (range 50-200). The median hospital stay was 8 days (range 6-10) and there were no major perioperative complications reported. At median follow up of 22 months (range 4-38), there were no recurrences of strictures or any other complications.

Conclusions: We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter. Numbers are still small but its application is likely to grow further.

No MeSH data available.


Related in: MedlinePlus

Picture showing port placement for laparoscopic right ileal ureter: 10 mm port above umbilicus for camera; 12 m port x 2.5 cm above and below the umbilicus, 5 mm port 1 cm below the xiphoid for liver retraction and additional 12 mm port in right iliac fossa for Endo–GIA stapler.
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Figure 0002: Picture showing port placement for laparoscopic right ileal ureter: 10 mm port above umbilicus for camera; 12 m port x 2.5 cm above and below the umbilicus, 5 mm port 1 cm below the xiphoid for liver retraction and additional 12 mm port in right iliac fossa for Endo–GIA stapler.

Mentions: A conventional laparoscopy set and 30° telescope is used. The patient is placed in a lateral position. A transperitoneal approach is used in all of our patients. Ports were positioned as follows: 10 mm port at the level of the umbilicus for camera, two additional 12 mm ports 5 cm above and below the umbilicus, and one 5 mm port 1 cm below the xiphoid for liver retraction for right–sided surgery. All the ports are placed in the midline. An additional 12 mm port is placed in either right or left iliac fossa to facilitate the application of Endo–GIA stapler (Figure 2).


Intracorporeal ileal ureter replacement using laparoscopy and robotics.

Sim A, Todenhöfer T, Mischinger J, Halalsheh O, Boettge J, Rausch S, Bier S, Aufderklamm S, Stenzl A, Gakis G, Schwentner C - Cent European J Urol (2014)

Picture showing port placement for laparoscopic right ileal ureter: 10 mm port above umbilicus for camera; 12 m port x 2.5 cm above and below the umbilicus, 5 mm port 1 cm below the xiphoid for liver retraction and additional 12 mm port in right iliac fossa for Endo–GIA stapler.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4310887&req=5

Figure 0002: Picture showing port placement for laparoscopic right ileal ureter: 10 mm port above umbilicus for camera; 12 m port x 2.5 cm above and below the umbilicus, 5 mm port 1 cm below the xiphoid for liver retraction and additional 12 mm port in right iliac fossa for Endo–GIA stapler.
Mentions: A conventional laparoscopy set and 30° telescope is used. The patient is placed in a lateral position. A transperitoneal approach is used in all of our patients. Ports were positioned as follows: 10 mm port at the level of the umbilicus for camera, two additional 12 mm ports 5 cm above and below the umbilicus, and one 5 mm port 1 cm below the xiphoid for liver retraction for right–sided surgery. All the ports are placed in the midline. An additional 12 mm port is placed in either right or left iliac fossa to facilitate the application of Endo–GIA stapler (Figure 2).

Bottom Line: Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery.We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter.Numbers are still small but its application is likely to grow further.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Eberhard-Karls University, Tuebingen, Germany.

ABSTRACT

Introduction: Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery. We report our experience using minimally invasive techniques for total intracorporeal ureteral replacement.

Material and methods: A chart review revealed five patients who underwent intracorporeal ileal ureter using minimally invasive techniques in the preceding 5 years. 4 patients underwent conventional laparoscopic surgery and 1 patient underwent robotic-assisted surgery. Patient's characteristics, perioperative data and functional outcomes as well as a detailed description of surgical technique are reported. In all 5 of these patients, the ileal ureter was performed completely intracorporeally.

Results: The median age of our patients is 61 (range 42-73). The median operative time was 250 minutes (range 150-320) and median blood loss was 100 ml (range 50-200). The median hospital stay was 8 days (range 6-10) and there were no major perioperative complications reported. At median follow up of 22 months (range 4-38), there were no recurrences of strictures or any other complications.

Conclusions: We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter. Numbers are still small but its application is likely to grow further.

No MeSH data available.


Related in: MedlinePlus