Laparoscopy-assisted ureter interposition by ileum

Abstract

Purpose: To report our experience with the laparoscopic approach to managing ileal ureter substitution for extensive ureteral stenosis. Patients and Methods: Two patients, one man and one woman, ages 38 and 51 years, respectively, underwent laparoscopic ileal substitution between March 2004 and December 2005 because of extensive ureteral stenosis after stone disease management. A three-port technique was used. The ileal segment was managed extracorporeally through a McBurney incision. Pyeloileal or ileoureteral anastomosis was performed intracorporeally. Follow-up included clinical evaluation, nuclear renography, intravenous urography. and serum chemistry analysis. Results: There were no complications, and there was minimal blood loss. Mean operative time was 195 minutes (range 180-210 min). Both patients remain without any symptoms or complaints at a median of 18.5 months follow-up (range 8-29 months). Postoperative pyelography verified adequate excretion from the renal unit. Nuclear