Prevention of ureteral damage by using ureteral illuminating catheter during laparoscopic surgery

Abstract

It has been reported that the incidence of ureteral injury during laparoscopic surgery is higher than during laparotomy. Accordingly, we investigated the usefulness and safety of ureteral illuminating catheters during gynecological surgery. Two patients underwent laparoscopic assisted vaginal hysterectomy and laparoscopic hysterectomy with the use of ureteral illuminating catheters. After introduction of the laparoscope, the catheters were clearly seen within the ureters through the pelvic peritoneum, facilitating dissection of the ureters and control of periureteric bleeding. Regarding the complications of ureteral illuminating catheters, lumbar backache was noted postoperatively in one patient, but it resolved after one day. No other complications were found. This method can be applied for training in laparoscopy at teaching hospitals, as well as in technically challenging cases where identification of the ureters is likely to be difficult, e.g. patients with severe pelvic adhesions, severe endometriosis, and malignant tumours. To assess the safety of ureteral illuminating catheters, we will investigate more cases in the future.