Laparoscopic ureteroureterostomy for retrocaval ureter

Objectives: To debate the different laparoscopic approaches for the surgical management of patients with circumcaval ureter. Methods: Updated literature review and discussion of personal experiences concerning the laparoscopic treatment of the circumcaval ureter. Results: Laparoscopic approaches promote less intraoperative bleeding, a shorter postoperative hospital stay, reduced postoperative pain, earlier return to daily activities and a significant superior aesthetics effect, while preserving therapeutic efficacy in performing reanastomosis of a circumcaval ureter. The main limiting factor for both a transabdominal and a retroperitoneal laparoscopic repair is the intracorporeal anastomosis of the ureter, which significantly increased the surgical time. Interestingly, a laparoscopic pyelopyelostomy for retrocaval ureter without resection of the retrocaval segment has been debated. Conclusions: Comparisons among historical reports regarding open surgery and laparoscopic transposition and reanastomosis of a circumcaval ureter have clearly shown the advantages of minimally invasive approaches.

Duke Scholars

Author Thomas James Polascik Urology