Use of observed ureteric catheter movement to facilitate laparoscopic identification and dissection of the ureter in complex gynaecological procedures

Abstract

Ureteric injury is a serious complication in gynaecological surgery. Identification and dissection of the ureter is important to minimise the risk of injury. However, some pelvic pathologies and previous pelvic surgery can render laparoscopic identification and dissection of the ureter difficult and risky. This video demonstrates the use of observing ureteric catheter movement to facilitate identification and dissection of the ureter in complicated laparoscopic gynaecological procedures. A 42-year-old woman with previous history of total abdominal hysterectomy underwent laparoscopic removal of her right ovary, which was plastered over the course of the ureter. A 5-F ureteric catheter was inserted, and observing its movement facilitated identification and dissection of the ureter from the ovary. The procedure was completed safely, and the patient was discharged the same day. This video demonstrates that moving the ureteric catheter laparoscopically to facilitate identification and dissection of the ureter in complex gynaecological procedures may be useful for urogynecologists when assisting ureteric dissection in complex cases.