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Laparoscopic repair of ureteral injuries
Authors:Tulikangas P K  Gill I S  Falcone T
Affiliation:Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Abstract:STUDY OBJECTIVE: To assess the outcome of laparoscopic repair of pelvic ureter injuries. DESIGN: Retrospective case series (Canadian Task Force classification II-2). SETTING: Large urban tertiary care medical center. PATIENTS: Four women who had pelvic ureter injuries and laparoscopic repair during laparoscopic gynecologic procedures. INTERVENTION: Laparoscopic ureteroureterostomy. MEASUREMENTS AND MAIN RESULTS: All injuries were identified immediately and repaired laparoscopically. No patient required repeat surgery. On assessment by physical examination, serum creatinine, and intravenous urogram, no patient had evidence of renal insufficiency. One woman had a narrowing at the site of ureteroureterostomy 6 weeks after repair; it was resolved on urogram 8 months after the injury. CONCLUSION: Laparoscopic ureteroureterostomy is feasible in some cases of ureteral injury. Experience with laparoscopic suturing is necessary to perform this procedure.
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