Laparoscopic ureter reimplantation
Laparoscopic ureter reimplantation, or neoimplantation, involves repositioning the ureter and reconnecting the endings to another spot on the urine bladder – which is to say away from the primary anatomical connection between the ureter and the urine bladder. It is performed transperitoneally.
When is it needed?
Laparoscopic ureter reimplantation is performed when there is significant or complete blockage of urine through the ureter, which can be a consequence of a variety of benign pathological processes that endoscopic methods were unsuccessful at treating.
How is it performed?
Laparoscopic reimplantation is normally done via the transabdominal laparoscopic approach, with the aid of four trocars. After removing the pathologically affected segment of the ureter, we insert a drainage catheter (a double-J or a S-catheter) into the ureter, and a urinary catheter into the urine bladder. At the anatomically appropriate spot in the urine bladder wall, we create a new point of connection between the ureter and the bladder, by a certain suturing technique. In order to control possible bleeding and/or urinary secretion, we also insert the drainage tube. The trocars are removed, and the incisions are stitched up.
What are the possible complications?
Complications in laparoscopic reimplantation are rare. The most common possible complication is bleeding, which rarely requires a blood transfusion. There are also general risks of laparoscopic surgery, such as the damage of stomach organs. However, these risks are minimal and occur in less than 1% of all patients. Approximately less than 2% of laparoscopic reimplantation surgeries require a conversion to the open surgical approach.
