Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic “reverse 7” ileal ureteral replacement for bilateral extensive ureteral strictures performed completely intracorporeally: the initial experience

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

To present our initial experience and evaluate the feasibility of the novel technique of completely intracorporeal laparoscopic “reverse 7” ileal ureteral replacement (IUR).

Materials and methods

Between December 2018 and September 2019, two patients underwent completely intracorporeal laparoscopic “reverse 7” IUR, which were female patients with bilateral extensive ureteral strictures (BEUS) secondary to radical hysterectomy and pelvic lymph node dissection for cervical cancer and postoperative radiotherapy. Antegrade pyelography and retrograde pyelography showed BEUS preoperatively.

Results

The novel technique was performed successfully by the same surgeon without conversion to open surgery. The operating time of each patient was 420 min and 410 min, respectively. Meanwhile, the estimated blood loss of each patient was 120 ml and 100 ml, respectively. There were no major complications during the perioperative period. After ureteral stent was removed, antegrade pyelography postoperatively revealed excellent drainage with the resolution of hydronephrosis in both patients. After removing of ureteral stent and nephrostomy tube, no patients have a complaint about the donor site or the onset of flank pain.

Conclusions

To our knowledge, we present the initial experience with completely intracorporeal laparoscopic “reverse 7” IUR. With initial follow-up outcomes, this novel minimally invasive technique appears to be feasible and efficacious in treating BEUS in carefully selected patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

BEUS:

Bilateral extensive ureteral strictures

IUR:

Ileal ureteral replacement

CT:

Computerized tomography

References

  1. Gomez-Gomez E, Malde S, Spilotros M, Shah PJ, JGOckrim TJL (2016) A tertiary experience of ileal-ureter substitution: Contemporary indications and outcomes. Scand J Urol 50(3):192–199. https://doi.org/10.3109/21681805.2015.1106579

    Article  PubMed  Google Scholar 

  2. Zhong W, Du Y, Yang K, Meng S, Lin R, Li X, Zhuang L, Cai L, Cui H, He Z, Zhou L (2017) Ileal ureter replacement combined with boari flap-psoas hitch to treat full-length ureteral defects: technique and initial experience. Urology 108:201–206. https://doi.org/10.1016/j.urology.2017.07.014

    Article  PubMed  Google Scholar 

  3. Kim A, Nam W, Song SH, Jeong IG, Hong B (2018) Use of the ileum for ureteral stricture and obstruction in bilateral, unilateral, and single-kidney cases. Urology 111:203–207. https://doi.org/10.1016/j.urology.2017.08.008

    Article  PubMed  Google Scholar 

  4. Wein AJ, Kavoussi LR, Partin AW, Peters C (2016) Campbell-walsh urology. Elsevier, Philadelphia

    Google Scholar 

  5. Xu YM, Feng C, Kato H, Xie H, Zhang XR (2016) Long-term outcome of ileal ureteric replacement with an iliopsoas muscle tunnel antirefluxing technique for the treatment of long-segment ureteric strictures. Urology 88:201–206. https://doi.org/10.1016/j.urology.2015.11.005

    Article  PubMed  Google Scholar 

  6. Li B, Xu Y, Hai B, Liu B, Xiang Y, Hua X, Hou T (2016) Laparoscopic onlay lingual mucosal graft ureteroplasty for proximal ureteral stricture: initial experience and 9-month follow-up. Int Urol Nephrol 48(8):1275–1279. https://doi.org/10.1007/s11255-016-1289-9

    Article  PubMed  Google Scholar 

  7. Xu Y, Pan F, Liu D, Yang X, Li S, Zhang Q, Li B (2018) Laparoscopic radical cystectomy with intracorporeal ileal conduit diversion: modified techniques and long-term outcomes. Surg Pract 22(3):125–130. https://doi.org/10.1111/1744-1633.12309

    Article  Google Scholar 

  8. Hasson HM (1971) A modified instrument and method for laparoscopy. Am J Obstet Gynecol 110(6):886–887. https://doi.org/10.1016/0002-9378(71)90593-x

    Article  CAS  PubMed  Google Scholar 

  9. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae

    Article  PubMed  PubMed Central  Google Scholar 

  10. Iwaszko MR, Krambeck AE, Chow GK, Gettman MT (2010) Transureteroureterostomy revisited: long-term surgical outcomes. J Urol 183(3):1055–1059. https://doi.org/10.1016/j.juro.2009.11.031

    Article  PubMed  Google Scholar 

  11. Mauck RJ, Hudak SJ, Terlecki RP, Morey AF (2011) Central role of Boari bladder flap and downward nephropexy in upper ureteral reconstruction. J Urol 186(4):1345–1349. https://doi.org/10.1016/j.juro.2011.05.086

    Article  PubMed  Google Scholar 

  12. Ordorica R, Wiegand LR, Webster JC, Lockhart JL (2014) Ureteral replacement and onlay repair with reconfigured intestinal segments. J Urol 191(5):1301–1306. https://doi.org/10.1016/j.juro.2013.11.027

    Article  PubMed  Google Scholar 

  13. Shoemaker GE (1911) VIII. Removal of the ureter with a tuberculous kidney. Ann Surg 53(5):696–698. https://doi.org/10.1097/00000658-191105000-00008

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Goodwin WE, Winter CC, Turner RD (1959) Replacement of the ureter by small intestine: clinical application and results of the ileal ureter. J Urol 81(3):406–418. https://doi.org/10.1016/s0022-5347(17)66035-x

    Article  CAS  PubMed  Google Scholar 

  15. Armatys SA, Mellon MJ, Beck SDW, Koch MO, Foster RS, Bihrle R (2009) Use of ileum as ureteral replacement in urological reconstruction. J Urol 181(1):177–181. https://doi.org/10.1016/j.juro.2008.09.019

    Article  PubMed  Google Scholar 

  16. Simmons MN, Gill IS, Fergany AF, Kaouk JH, Desai MM (2007) Laparoscopic ureteral reconstruction for benign stricture disease. Urology 69(2):280–284. https://doi.org/10.1016/j.urology.2006.09.067

    Article  PubMed  Google Scholar 

  17. Stein RJ, Turna B, Patel NS, Weight CJ, Nguyen MM, Shah G, Aron M, Fergany AF, Gill IS, Desai MM (2009) Laparoscopic assisted ileal ureter: technique, outcomes and comparison to the open procedure. J Urol 182(3):1032–1039. https://doi.org/10.1016/j.juro.2009.05.013

    Article  PubMed  Google Scholar 

  18. Waldner M, Hertle L, Roth S (1999) Ileal ureteral substitution in reconstructive urological surgery: is an antireflux procedure necessary? J Urol 162(2):323–326

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are very grateful for the help of the entire staff of the Department of Urology and Operation Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.

Funding

This study was funded by grants from the National Natural Science Foundation of China (NSFC, Grant No. 81671216) and Wuhan Municipal Science and Technology Bureau (CN, Grant No. 2020020601012222) to Bing Li.

Author information

Authors and Affiliations

  1. Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No. 1277, Wuhan, 430022, China

    Chaoqi Liang, Shuaishuai Chai, Xincheng Gao, Jianli Wang, Dong Ni, Teng Hou, Xingyuan Xiao, Wencheng Li & Bing Li

  2. School of Electronic Information and Communications, Huazhong University of Science and Technology, Wuhan, China

    You Yang

Authors
  1. Chaoqi Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shuaishuai Chai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xincheng Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jianli Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dong Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Teng Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xingyuan Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. You Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wencheng Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Bing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bing Li.

Ethics declarations

Conflict of interest

All the authors had no conflicts of interest to declare in relation to this article.

Ethical approval

All procedures performed in studies involving human participant were in accordance with the ethical standards of the Institutional Review Board of Union Hospital, Huazhong University of Science and Technology, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The authors declared that informed consent was obtained from the individual participant included in this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liang, C., Chai, S., Gao, X. et al. Laparoscopic “reverse 7” ileal ureteral replacement for bilateral extensive ureteral strictures performed completely intracorporeally: the initial experience. Int Urol Nephrol 53, 919–924 (2021). https://doi.org/10.1007/s11255-020-02751-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-020-02751-0

Keywords

Search

Navigation