Laparoscopic extravesical detrusorraphy, a minimally invasive treatment option for vesicoureteral reflux: a single centre experience

Journal of Pediatric Urology
Tarun JavaliH K Nagaraj

Abstract

Laparoscopy in pediatric patients offers more benefits than was earlier presumed and these widely reported benefits significantly outweigh any concerns regarding the technical difficulties. Laparoscopic correction of vesicoureteral reflux aims to duplicate the excellent results of open surgery while at the same time reducing perioperative morbidity and analgesic requirements, improving cosmesis and shortening hospital stay. To share our experience of laparoscopic extravesical detrusorraphy, highlight our technical modification of intraoperative minimal "atraumatic" ureteric handling of the ureter, which we hypothesize may decrease ureteral complications, and report our results. This was a retrospective chart review of 76 toilet-trained children (98 refluxing units), in the age group of 3-16 years, with Grade I-IV reflux, who underwent laparoscopic detrusorraphy from June 2006 to January 2014. A ureteric catheter is inserted into the refluxing ureter and is tied to the Foleys to drain into a common bag. A three port technique is used. During ureteral dissection, a vascular sling in the form of a Rumel loop is used for atraumatic handling of the ureter. A detrusor tunnel is created with hook electrocautery. A stay suture is later...Continue Reading

References

May 9, 2001·The Journal of Urology·J LeissnerR Hohenfellner
Jun 29, 2004·World Journal of Urology·Axel HeidenreichGerald Haupt
Jun 27, 2006·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Mario RiquelmeCarlos Rodriguez
Mar 22, 2008·The Journal of Urology·Pasquale CasaleThomas F Kolon
Sep 23, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Yao C TsaiStephen S D Yang

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