Ureteral injury during laparoscopically assisted radical vaginal hysterectomy

We report on a case of ureteral injury during laparoscopicallyradical hysterectomy to treat a patient with a stage IA² carcinomaof the uterine cervix. The advantage of laparoscopically radicalhysterectomy is the prevention of the identification and dissectingof the ureter from a vaginal approach, the main problem in theSchauta technique. However, ureteral injury may still occurwhile resecting the cardinal ligament without good visualizationof the ureter during a vaginal procedure. Because the ureterwas well identified and freed laparoscopically, a vaginal approachafter uterine removal may be an option for treatment. Moreover,using the ureteral stent as a marker during a modified Schautatechnique is helpful in the prevention of ureteral injury duringlaparoscopically assisted radical vaginal hysterectomy.