Pure Laparoendoscopic Nephroureterectomy for Pelvic/Upper Ureteric Malignancy: Points of Technique with Outcome Analysis

Abstract

Abstract Introduction: The optimal treatment for unilateral pelvic/upper ureteric malignancy with contralateral salvageable renal unit is radical nephroureterectomy with bladder cuff. Although this radical surgical exercise can be well accomplished through a minimally invasive approach, several technical variations of this exercise have been in vogue.1,2 We present a video demonstration of our technique of pure laparoendoscopic radical nephroureterectomy, discuss the key aspects of this technique, and analyze the outcome. Methods: Patients were evaluated in detail. Imaging included ultrasonogram, computed tomogram urography, or magnetic resonance urogram. Cystoscopy was performed to rule out bladder pathologies. Patients with unilateral pelvic or upper ureteric lesions of probable malignant etiology were offered laparoendoscopic extirpation following the same technique. First, endoscopic management of the ureteric orifice was undertaken. The periureteric resection margin was point mapped, followed by deep...