Laparoscopic ureteroplasty with gonadal vein graft for long ureteral stenosis: A step by step video

Strictures of the ureter may occur from iatrogenic injury or impacted kidney stones. Complications from ureteroscopy may result in ureteral stricture in 0,5–2% of patients. New techniques are being described in order to minimize the morbidity associated with classic approaches. This is a step-by-ste...

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Bibliographic Details
Published in:Journal of pediatric urology 2020-10, Vol.16 (5), p.729-730
Main Authors: Paludo, Artur de Oliveira, Menegola, Conrado, Gorgen, Antonio Rebello Horta, Diaz, Johanna Ovalle, da Silva Batezini, Nelson Sivonei, Tavares, Patric Machado, Rosito, Tiago Elias
Format: Article
Language:English
Subjects:
Gonadal vein
Graft
Laparoscopic
Ureteral reconstruction
Ureteral stenosis
Ureteroplasty
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Summary:Strictures of the ureter may occur from iatrogenic injury or impacted kidney stones. Complications from ureteroscopy may result in ureteral stricture in 0,5–2% of patients. New techniques are being described in order to minimize the morbidity associated with classic approaches. This is a step-by-step video of this novel technique: a successful laparoscopic ureteroplasty with gonadal vein graft for a iatrogenic long ureteral stenosis. A 16 year old female patient, with multiple previous ureteroscopies for ureteral stones, presented with severe left lumbar pain. An abdominal CT and a pyelography were performed showing a 3 cm left mid-proximal ureteral stricture with proximal hydronephrosis. The stenotic area was identified and an anterior left ureteral incision was made. Gonadal vein was removed and prepared, being sutured in the anterior surface of the ureter. Patient was discharged in the second post operative (PO). JJ stent was removed after 1 month. A 3 month PO pyelography was performed, showing no fistula and resolution of the stricture. Twelve months after surgery, the patient was painless with symptom resolution. The use of gonadal vein as a graft for ureteral strictures is a new possible approach, although more cases are necessary to evaluate its results.
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2020.09.016