Laparoscopic ureterolysis in retroperitoneal fibrosis.

We reported on 5 patients with retroperitoneal fibrosis with dilatation of the upper urinary tract. All patients were operated on laparoscopically. Surgery consisted of complete ascending ureterolysis from the pelvis up to the renal pelvis, biopsy of periureteral tissue, intraperitonealisation and/or preparing an omental flap to separate the ureters from the retroperitoneal vessels. Operating time was reduced from 4 hours in a unilateral case down to 5 hours in a bilateral case by performing three-dimensional video endoscopy. In case of Ormond's disease postoperative immunosuppressive medication was given. Ureterolysis in Ormond's disease is a rare but reasonable indication for reconstructive laparoscopic surgery. Both ureters are accessible in full length either transperitoneal or retroperitoneal. Provided all goals of open surgery can be achieved by the laparoscopic technique, patients will benefit from the minimal access.