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Laparoscopic ureterolysis and reconstruction of a retrocaval ureter

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Abstract

A 32-year-old man was investigated for repeated episodes of right-sided flank pain. Ultrasonography showed a dilated right pelvicalyceal system and upper ureter as well as multiple gallstones; subsequent intravenous urogram demonstrated a retrocaval ureter. At surgery, a right-sided double-J ureteric stent was placed under fluoroscopic guidance. Initially, three laparoscopic ports were used. The dilated pelvis and upper ureter were mobilized, followed by the lower ureter. The pelvis was transected and transposed anterior to the inferior vena cava. Reconstruction was carried out with an intracorporeally sutured anastomosis over the double-J stent. A fourth port was added for completion of cholecystectomy. The patient had an uneventful recovery and was discharged on the third day. Fourteen months later he remains well, with a recent intravenous urogram showing regression of hydronephrosis. We review the previously reported cases of laparoscopic and retroperitoneoscopic reconstruction of retrocaval ureter to compare and contrast these minimal access approaches.

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Authors and Affiliations

  1. Department of Surgery, Sir Hurkisondas Nurrotumdas Hospital and Research Center, Raja Ram Mohan Roy Road, Mumbai 400 004, India

    D. S. Bhandarkar

  2. Department of Urology, Sir Hurkisondas Nurrotumdas Hospital and Research Center, Raja Ram Mohan Roy Road, Mumbai 400 004, India

    J. G. Lalmalani

  3. Department of Urology, Deenanath Mangeshkar Hospital and Research Center, 23, Karve Road, Pune 411 004, India

    S. Shivde

Authors
  1. D. S. Bhandarkar
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  2. J. G. Lalmalani
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  3. S. Shivde
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Correspondence to D. S. Bhandarkar.

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Bhandarkar, D., Lalmalani, J. & Shivde, S. Laparoscopic ureterolysis and reconstruction of a retrocaval ureter . Surg Endosc 17, 1851–1852 (2003). https://doi.org/10.1007/s00464-003-4513-5

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  • DOI: https://doi.org/10.1007/s00464-003-4513-5

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