Value of ureteral catheterization in laparoscopy]

OBJECTIVE: Describe indications and procedures of ureteral retrograde catheter placement in operative laparoscopy. Assess the security that allows this technique to avoid or detect ureteral injury. STUDY DESIGN: A cohort study over a five year period was performed on 1722 patients who underwent an operative gynecologic laparoscopy. SURGICAL TECHNIQUE: When presumptive evidence of ureter adhesiolysis (dense adhesions from previous surgery, endometriosis), or suspicion of iatrogenic ureter transection, laparoscopic procedure was interrupted. A cystoscopy was performed and an internalized stent was inserted. RESULTS: In nine cases (preventive indications), patients required this procedure in adnexal surgery (dense adhesions from previous operations endometriosis), in oophorectomy for residual ovary syndrome and ovarian remnant syndrome and in hysterectomy with an intraligamentary leiomyomata. In one case (diagnostic indication), ureteral catheter placement was performed after use of an endoscopic linear stapler during a laparoscopically assisted vaginal hysterectomy. CONCLUSION: This intra-operative procedure can allow better ureter recognition and its safe dissection when complex operative laparoscopy is foreseen.