Laparoscopic Boari Flap Repair: Report of 3 Cases

Abstract

Boari flap reimplantation is one of the options for ureteric reimplantation when the diseased ureteric segment is long. Open Boari flap reimplantation is well established. In this paper, we describe laparoscopic Boari flap reimplantation in 3 patients. Since May 2004, 3 patients had a successful laparoscopic Boari flap ureteric reimplantation. Preoperative intravenous urogram and retrograde pyelogram confirmed the length and site of the obstruction. The first patient was a 16-year-old boy with primary obstructive megaureter, with the adynamic segment extending from just below the sacro iliac joint. The second was a middle-aged diabetic lady with a long lower ureteric stricture. The third was a ureteric injury that occurred following a laparoscopic ovarian cystectomy. The mean operative time was around 320 minutes. There were no intra- or postoperative complications. All the patients recovered well and are being followed up clinically and radiologically. Laparoscopic Boari flap reimplantation is a challenging procedure. With increasing technical skill and confidence, one can attempt the procedure with the obvious advantage to the patient.