Laparoscopic ipsilateral ureteroureterostomy in the management of ureteral ectopia in infants and children.

OBJECTIVE

We report our initial experience, and describe our technique, in performing laparoscopic ipsilateral ureteroureterostomy (IUU) in the pediatric population.

MATERIALS AND

METHODS

An IRB-approved, retrospective review of all patients undergoing laparoscopic IUU at our institution between 2006 and 2009 was performed. Demographic data, mode of presentation, underlying diagnosis, operative parameters, complications and follow-up data were analyzed. Cystoscopy, retrograde pyelograms and ureteral stent placement into the lower pole ureter were performed at the beginning of all cases. All were performed via a transperitoneal approach. An end-to-side ureteral anastamosis was carried out along the proximal lower pole ureter. No drains were left in place. Urethral catheters were left for 48 h.

RESULTS

There were seven patients in the series. All were female with a mean age of 84 months (11190). Diagnosis was an ectopic ureter in six patients and a ureterocele in one patient. No patient required conversion to an open approach. Mean total operative time was 187 min (140252). Mean hospital stay was 2 days (14) with a mean follow up of 8 months (115). No complications occurred postoperatively. Follow-up studies demonstrate decreased or resolved hydronephrosis in all cases.

CONCLUSIONS

In our initial experience, laparoscopic IUU can be accomplished in a safe and effective manner with minimal complication.