V1709 ROLE OF LAPAROSCOPY IN URINARY DIVERSION IN CHILDREN: DESCRIPTION OF DIFFERENT URETEROSTOMY TECHNIQUES

Abstract

You have accessJournal of UrologyPediatrics & Reconstruction1 Apr 2011V1709 ROLE OF LAPAROSCOPY IN URINARY DIVERSION IN CHILDREN: DESCRIPTION OF DIFFERENT URETEROSTOMY TECHNIQUES Yaser El-Hout, Tarek H. El-Ghazaly, and Walid A. Farhat Yaser El-HoutYaser El-Hout Toronto, Canada More articles by this author , Tarek H. El-GhazalyTarek H. El-Ghazaly Toronto, Canada More articles by this author , and Walid A. FarhatWalid A. Farhat Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2034AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In pediatric urology, upper tract urinary diversion in the form of cutaneous ureterostomy may be clinically indicated as a temporizing procedure whenever the definitive reconstructive surgery has to be delayed for technical or clinical considerations. With expansion of the application of pediatric minimally invasive approaches, performing laparoscopic urinary diversion is an attractive alternative, owing to better visualization and limited dissection, hence a perceived decreased adhesions in the secondary definitive reconstruction. Herein, we describe two cases of laparoscopic ureterostomy, performed through different approaches:retroperitoneal and transperitoneal. METHODS This is a single center case study that reports on the clinical presentation, indications for urinary diversion, and description of surgical technique and short-term postoperative outcome on two pediatric patients that underwent retroperitoneoscopic unilateral cutaneous end ureterostomy and laparoscopic bilateral loop ureterostomies. RESULTS Retroperitoneal approach is ideal for unilateral ureterostomy creation, as it allows for direct access to the ureter along its entire course on the psoas. Transperitoneal approach is beneficial for bilateral creation, or whenever a diagnostic laparoscopy is clinically desired. In our reported patients, no intraoperative complications were encountered. Ultrasound and physical examination at three months follow-up confirmed upper tract decompression, stable renal function and patent stomas. CONCLUSIONS When indicated,minimally invasive urinary diversion, in the form of ureterostomies, is a feasible alternative in the pediatric population. Owing to the rarity of this entity, pediatric urologists may opt for this alternative in select patients. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e687 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yaser El-Hout Toronto, Canada More articles by this author Tarek H. El-Ghazaly Toronto, Canada More articles by this author Walid A. Farhat Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...