Editorial Comment

Abstract

The authors present an interesting modification of the pluck technique by circumcision of the orifice during or before laparoscopic nephroureterectomy. The intraureteral injection of collagen glue (Tisseel) may occlude the distal ureter and avoid tumor cell spillage. The concept was tested clinically by intraoperative intravenous injection of indigo carmine. After sufficient occlusion, the ureter appears dilated and blue in color. Ureteral Fibrin Sealant Injection of the Distal Ureter During Laparoscopic Nephroureterectomy—A Novel and Simple Modification of the Pluck TechniqueUrologyVol. 75Issue 1PreviewTo describe a novel technique to block the distal ureter, thus preventing spillage of tumor cell bearing urine during laparoscopic pluck nephroureterectomy. Currently, there is no consensus on the appropriate management of distal ureter during laparoscopic nephroureterectomy. Full-Text PDF ReplyUrologyVol. 75Issue 1PreviewManagement of the distal ureter remains controversial in the treatment of UTTCC. Although multiple modifications have been reported, 2 important goals remain as constants: (1) en bloc removal of the bladder cuff with the nephroureterectomy specimen and (2) prevention of spillage of tumor cell–laden urine in the extravesical tissues. These goals may be accomplished by a variety of surgical techniques. Our proposed technique satisfies both the stated goals, in addition to being simple and easily reproducible. Full-Text PDF