Laparoscopic Ureteroneocystostomy Research Articles

Laparoscopic ureteroneocystostomy with bladder flap for benign ureteral stenosis: our initial experience

To present our experience with laparoscopic ureteroneocystostomy with bladder flap (LUCBF) for treating benign ureteral stenosis and evaluate its feasibility and efficacy. The clinical data of 27 patients with benign ureteral stenosis who underwent LUCBF were retrospectively analyzed. After identification and excision of the ureteral stenosis segment, the healthy ureteral stump was dissected and incised longitudinally. A U-shaped or spiral bladder flap was harvested from the anterolateral bladder wall for ureteroplasty. All patients underwent LUCBF successfully, including 14 patients were combined with psoas hitch technique, between 90 and 220 min (median, 155 min). The median length of ureteral defect was 6 cm (range, 5–17 cm). The median blood loss was 40 ml (20–150 ml). The median indwelling time of double-J stent was 8 weeks (range, 4–8 weeks). Five patients (10.6%) suffered postoperative complications during the follow-up period (range, 12–48 months), including fever, hematuria, urinary tract infection and recurrent stenosis. The success rate was 96.3% (26/27). Patients with long ureter defects had longer operative time and more blood loss than short ureter defects. LUCBF was a safe and feasible technique for benign ureteral stenosis. Long ureter defect was related to longer operative time and more blood loss.

Laparoscopic ureteroneocystostomy in the treatment of urinary incontinence due to ectopy of the ureters in female dogs: A pilot study.

Ureteral ectopia is rare and requires surgical treatment after a thorough diagnostic workup. Open surgical techniques for repositioning ectopic ureters have been known for many years and are well described in the literature. However, to the best of our knowledge, no laparoscopic method of correcting this pathology has been described, which, in our opinion, would benefit the animal in terms of the healing process and overall clinical outcomes. This study aimed to evaluate the possibility of laparoscopic treatment of ureteral ectopia, which causes urinary incontinence in dogs. All of the operated ten dogs presented in this study were client-owned females with symptoms of urinary incontinence due to a unilateral intramural ectopic ureter. A three-trocar laparoscopic technique was used to perform the ureteroneocystostomy of the ectopic ureter. In this article, clinicopathological data, imaging features, procedural findings, complications, and short- and long-term outcomes are presented. The procedure was feasible in all cases. No major postoperative complications were observed. Among the minor complications, slight hematuria was observed in three dogs, which resolved spontaneously. In the period of at least one year after surgery, no negative impact of the procedure was observed. Seven of the ten operated dogs regained urinary continence. The remaining three dogs required additional surgery (urethral bulking) because of a lack of improvement after adjuvant pharmacological treatment. Overall, good-to-excellent long-term outcomes can be achieved; however, dogs that remain incontinent after laparoscopic ureteroneocystostomy may require additional treatment.

A retrospective comparison between laparoscopic and open ureteroneocystostomy for management of benign lower ureteral strictures: An experience in tertiary care centre of Eastern India.

The objective is to discover the etiopathogenesis of benign lower ureteric stricture in Eastern India and compare the outcome of open versus laparoscopic ureteroneocystostomy. Retrospectively 52 patients who underwent laparoscopic (n = 28) or open ureteroneocystostomy (n = 24) for lower ureteral stricture between January 2018and December 2021 were included. The demography, aetiology, radiologic imaging, intraoperative & postoperative outcomes and follow-up data were collected and analysed. The mean duration of follow up was 14.3 months. Lower ureteric stricture were common in females. The most common cause of the stricture was iatrogenic injury (42%). Other causes were tuberculosis, post-endourological surgery, obstructing mega ureter, endometriosis and idiopathic. Laparoscopic surgery had longer mean operative time (228 vs 171 min), less blood loss (166 vs 246 ml), lower VAS score (6.1 vs 7.22) and less need of post-operative analgesia (1.86 vs 2.36 days). The hospital stay (5.36 vs 6.77 days) and post-operative complications (none vs 3) were also significantly lower in laparoscopic group. Open surgery and laparoscopic surgery had success rate of 100% and 96.6% each. Iatrogenic injury are the most common cause of ureteric stricture followed by tuberculosis. Laparoscopic approach is a feasible option in treatment of lower ureteric stricture as it offer comparable outcome to open procedure while offering the advantage of a minimal invasive technique. Stricture secondary to iatrogenic injury poses a different challenge due to presence of hard dense fibrosis. This is a complex reconstructive procedure and has a steep learning curve and demands high level of laparoscopic skill.

Robotic-Assisted Laparoscopic Excision of Deep Infiltrating Endometriosis with Concomitant Left Ureteroneocystostomy

<h3>Study Objective</h3> To describe the surgical techniques employed to effectively excise deep infiltrating endometriosis involving the ureters and to highlight the successful re-implantation of the left ureter. <h3>Design</h3> Video presentation. <h3>Setting</h3> Academic tertiary care center. <h3>Patients or Participants</h3> This is the case of a 45-year-old G1P1001 patient with a history of chronic pelvic pain and endometriosis. She underwent previous exploratory laparotomy due to endometriosis. Her symptoms however recurred and worsened to the point where she started experiencing left flank pain. A CT scan revealed moderate left hydroureteronephrosis to the level of the left adnexa. MRI findings confirmed the left ureter to be encased by pelvic endometriosis causing significant extrinsic compression. <h3>Interventions</h3> Intra-operatively, deep infiltrating endometriosis was noted involving the posterior cul-de-sac, bilateral uterosacral ligaments, with retroperitoneal fibrosis involving bilateral ureters. Retroperitoneal dissection was performed using a medial approach thus identifying the ureters bilaterally. Careful and extensive dissection was then carried out, excising the fibrotic endometriotic nodule from the ureters. The left hydroureter was transected at its most distal and narrowed portion by the urology team. The proximal end for re-implantation was then spatulated. The bladder was mobilized, and a tension free re-implantation was successfully completed after placing a double pig-tail stent in a retrograde fashion. A water-tight re-anastomosis was confirmed. <h3>Measurements and Main Results</h3> The patient recovered well from her procedure and had significant improvement in her pain symptoms when she was reviewed at her postoperative visit. <h3>Conclusion</h3> Despite its incessant, recalcitrant nature, endometriosis affecting the ureters can be effectively resected. Laparoscopic ureteroneocystostomy for ureteral endometriosis is safe, feasible, and can achieve good surgical outcomes leading to effective control of patient's symptoms as was noted in this case.

Laparoscopic ureteroneocystostomy and round ligament bladder hitching for ureteral stenosis in parametrial deep endometriosis: Our tips for a tension-free anastomosis.

To investigate the feasibility and the efficacy of laparoscopic ureteroneocystostomy with round ligament bladder hitching. This is a monocentric retrospective study. Enrolled patients affected by deep endometriosis underwent laparoscopic nerve-sparing parametrectomy and monolateral ureteroneocystostomy with bladder suspension to the round ligament. Perioperative and postoperative outcomes were collected, as well as urinary and pain symptoms before and after surgery. Laparoscopic ureteroneocystostomy with round ligament bladder hitching was performed in nine women. The most frequent postoperative complication was post-voiding urinary retention (22.2%). No ureteral fistula or stenosis of the anastomosis was reported. In selected cases of ureteral resection and reimplantation, performing a round ligament bladder hitching allowed us to overcome the ureteral gap. This is a safe and feasible procedure to ensure stability of the anastomosis and avoid the possible disadvantages of the "standard" psoas hitch procedure.

Open versus minimally invasive ureteroneocystostomy: trends and outcomes in a NSQIP-P cohort.

Although surgical intervention has commonly been performed using an open approach for vesicoureteral reflux (VUR), this is rapidly changing due to adoption of minimally invasive surgery (MIS). Success rates with MIS are similar to open for re-implantation (> 90%); however, open ureteral re-implantation is still widely considered the gold standard. Using national surgical quality improvement program-pediatric (NSQIP-P) data, this manuscript evaluates recent large population trends of open versus robotic-assisted and laparoscopic ureteroneocystostomy for complications and factors associated with worse outcomes. Cases were identified in the 2012-2019 NSQIP-P database using the ureteroneocystostomy operative codes and vesicoureteral reflux post-operative diagnosis codes. A 1:1 propensity score match (PSM) analysis was performed comparing surgical outcomes while matching patients with similar characteristics to reduce bias. A total of 4183 patients were included; 621 patients with MIS and 3562 with open approach. Patients in the MIS approach tended to be older (67months vs. 53months) and non-Caucasian (12.9% vs. 6.3%) with no differences in other demographics. After 1:1 PSM, 30-day complications after ureteroneocystostomy showed no significant differences in readmission, reoperation, or extended hospital stay. A multivariate analysis found patients with CNS structural abnormalities (such as spina bifida) had 4.5 times greater odds of experiencing a reoperation (pvalue < 0.05). Similarly, patients with an ASA above two had 2.0 times greater odds of an UTI (pvalue < 0.05). The cohorts undergoing open and MIS approaches are well matched overall, without profound differences in outcomes overall.

Rate of recurrent hydronephrosis after laparoscopic ureteroneocystostomy for ureteral endometriosis.

To investigate the short-term outcomes of laparoscopic ureteroneocystostomy in patients with ureteral endometriosis (UE). Retrospective cohort study of consecutive patients who underwent surgery for the ureter endometriosis with hydronephrosis. A private hospital that provide primary, secondary and tertiary care. 30 consecutive patients with UE who underwent laparoscopic ureteroneocystostomy at our institution between May 2008 and April 2020. Laparoscopic ureteroneocystostomy, if necessary, hysterectomy, salpingo-oophorectomy, cystectomy, partial bladder resection, or partial bowel resection were performed. The most common chief complaint was pelvic pain (40%). Endometriosis affected only the left ureter in 56.7% of patients, only the right ureter in 33.3%, and both ureters in 6.7%. Involvement of the ipsilateral ovary was confirmed in 64.3%. The most frequent location of UE was 1-3cm above the UVJ (46.7%). A psoas hitch was performed in 7 patients (23.3%), and the Boari flap was used in 9 patients (30%). Hysterectomy was performed in 12 patients (40%), and 6 of them had a concomitant bilateral salpingo-oophorectomy (20%). In addition, 3 patients (10%) underwent partial bowel resection, and 2 patients (6.7%) underwent partial bladder resection. After surgery, 24 of 27 patients (80.0%) were free of sever hydronephrosis after surgery. Hydronephrosis recurred in a single patient (3.3%), but the grade of hydronephrosis improved significantly after surgery (P < 0.001). At 6months of follow up, 4 patients (13.3%) experienced urinary tract infections and 2 patients (6.7%) reported dysuria. Patients reported a regression of dysmenorrhea symptoms (P < 0.001). This study shows that ureteroneocystostomy provides good results in terms of relapses and symptom control in patients with ureteral endometriosis.

Robotic-assisted laparoscopic excision of deep infiltrating endometriosis involving the left ureter with concomitant left ureteroneocystostomy

This is the case of a 45-year-old G1P1001 patient with a history of chronic pelvic pain and endometriosis. She underwent previous exploratory laparotomy due to endometriosis. Her symptoms however recurred and worsened to the point where she started experiencing left flank pain. A CT scan revealed moderate left hydroureteronephrosis to the level of the left adnexa. MRI findings confirmed the left ureter to be encased by pelvic endometriosis causing significant extrinsic compression. Intra-operatively, deep infiltrating endometriosis was noted involving the posterior cul-de-sac, bilateral uterosacral ligaments, with retroperitoneal fibrosis involving bilateral ureters. Retroperitoneal dissection was performed using a medial approach thus identifying the ureters bilaterally. Careful and extensive dissection was then carried out, excising the fibrotic endometriotic nodule from the ureters. The left hydroureter was transected at its most distal and narrowed portion. The proximal end for re-implantation was then spatulated. The bladder was mobilized, and a tension free re-implantation was successfully completed after placing a double pig-tail stent in a retrograde fashion. A watertight re-anastomosis was confirmed. The patient recovered well from her procedure and had significant improvement in her symptoms. Despite its incessant, recalcitrant nature, endometriosis affecting the ureters can be effectively resected. Laparoscopic ureteroneocystostomy for ureteral endometriosis is safe, feasible, and can achieve good surgical outcomes leading to effective control of patient’s symptoms as was noted in this case.

Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes

BackgroundExcellent success rates with short-term outcomes are noted for laparoscopic ureteral reconstruction (LUR) for iatrogenic ureteral injury. This multi-institutional study assessed the medium-term (>1 year) outcomes and compared three surgical techniques of LUR. MethodsPatients who underwent LUR at five tertiary hospitals between January 2007 and June 2016 were retrospectively analyzed. Patients with active abdominopelvic inflammatory disease, history of urothelial cancer, and tumor recurrence and those who received adjuvant chemotherapy or radiotherapy were excluded. ResultsThe success rates of LUR for 61 patients at 3 months postoperatively and at the last follow-up (at least 12 months postoperatively) were 100% and 95.1%, respectively. No significant difference was noted in the success rates of the three types of LUR. LUR was mainly performed in response to the demands of the primary surgeon responsible for the iatrogenic injury (33 of 45 cases, 73.3%). The vesicoureteral reflux (VUR) incidence was higher in the refluxing laparoscopic ureteroneocystostomy (LUN) group (40%) than in the anti-refluxing LUN group (15%, odds ratio: 1.5, p = 0.252). None of the patients in the LUN groups received treatment for VUR during the follow-up. The laparoscopic end-to-end ureteroureterostomy (LEEU) group had shorter operative time (p < 0.001) and lesser intraoperative blood loss (p < 0.001) than the LUN groups. ConclusionLUR is safe and feasible, with good medium-term outcomes. LEEU is a good surgical option in terms of the operative and subsequent outcomes. The anti-reflux technique in LUR reduces de-novo VUR development but is not necessary for preventing upper urinary tract infections in adults.

Robotic-assisted ureteral reimplantation and psoas hitch after ureteral injury during cesarean section.

Ureteral injury during gynecological surgery can be managed in a variety of ways, from endoscopic stent placement to ureteroneocystotomy with accompanying psoas hitch and/or Boari flap. The majority of these occur during hysterectomy; therefore, gynecologic surgeons may not be as familiar with repair in women with intact uteri. Herein we present our technique for delayed robotic-assisted ureteral reimplant and psoas hitch in a woman with a ureteral injury sustained during cesarean section, which initially presented as a uretero-cervical fistula. In this video, we describe the evaluation and surgical management of a patient with delayed recognition of a left distal ureteral injury sustained during cesarean section. We present necessary modifications to robotic-assisted laparoscopic ureteroneocystostomy and psoas hitch to accommodate an intact uterus including the need for uterine manipulation, division of the round ligament, bladder mobilization from the lower uterine segment and development of the retropubic space, reimplantation steps, and psoas hitch. Simple modifications to a traditional technique of robotic-assisted ureteroneocystotomy effectively compensate for the presence of a uterus. Obstetricians should maintain a high index of suspicion for ureteral injury in women with new-onset severe urinary leakage post-cesarean section.

Feasibility of robotic radical hysterectomy (RRH) with a new robotic system. Experience at Galaxy Care Laparoscopy Institute.

The main objective of this study was to assess in a series of 30 patients, the feasibility, oncological safety and efficacy of radical hysterectomy by a new robotic system. Prospective study design. Galaxy Care Laparoscopy Institute and Multispeciality Hospital. We performed Robotic Radical Hysterectomy in patients from August 2019 through February 2020. All the surgeries were performed by a single surgeon (Puntambekar S). Since August 2019, 30 patients with early cervical cancer/endometrial cancer were selected for radical hysterectomy. All patients were in good general condition with controlled medical comorbidities. The mean operative time was 104min, with mean total lymph node yield of 24.7. The average blood loss was 60ml and the hospital stay was 2.1days, and majority of the patients were catheter free by 1week. Two patients developed uretero-vaginal fistula on the 8th day of surgery. One was managed with Double J stenting and in the other we did laparoscopic ureteroneocystostomy. Our study has demonstrated the feasibility, safety and efficacy of RRH by the Versius robotic systems.

Robot-assisted laparoscopic ureteroneocystostomy combined to hysterectomy for intrinsic ureteral and deep pelvic endometriosis: Video presentation

Introduction: We present a case of posterior deep infiltrating endometriosis with intrinsic ureteral involvement in a 43-year-old patient treated by robot-assisted laparoscopic technique. To our knowledge, this is the second case of robot-assisted ureteroneocystostomy with concomitant hysterectomy reported in the literature1–5, yet the first one to be described with a video presentation. Case description: A 43-year-old woman with a past history of endometriosis treated laparoscopically was referred to our clinic for grade II–III left hydronephrosis. Pelvic ultrasound and magnetic resonance imaging demonstrated a 3-cm paracervical endometriotic nodule causing ureteral compression, another 1.6-cm endometriotic nodule at the rectosigmoid junction, an adenomyotic nodule in the anterior uterine wall, and an endometrioma on the right ovary. Given that the patient had an absolute contraindication to hormonal therapy, we opted for robot-assisted laparoscopic complete eradication of endometriosis. The procedure consisted in total hysterectomy with concomitant removal of the rectovaginal nodule, right adnexectomy, left salpingectomy, and left ureteral resection with ureteroneocystostomy. After 8 days, a cystography was accomplished to confirm anastomosis integrity, and the bladder catheter was removed. The patient was discharged on day 8 after a regular postoperative period. One year after the surgery, the patient refers wellbeing. Conclusion: The robotic approach in such a complex procedure as surgical treatment of ureteral and deep infiltrating endometriosis is feasible and safe with acceptable postoperative outcome. Further investigations with larger comparative cohorts that include cost analysis are needed to fully assess the benefits achieved by robotic assistance in patients with ureteral and deep infiltrating endometriosis.

Robot-assisted laparoscopic ureteroneocystostomy in adults: A single surgeon experience and literature review

ObjectiveTo present our experience and technique with robot-assisted ureteroneocystostomy (RAUN) procedure in adults. MethodsBetween February 2015 and August 2018, a total of 30 (34 ureters) patients who underwent RAUN surgery under a single surgeon were retrospectively reviewed. Perioperative data such as age, sex, body mass index (BMI), American society of anesthesiologists score, estimated blood loss, surgical technique, operative time, complications, length of hospital stay, and stent removal time were recorded. During the follow-up, patients underwent renal function test, urinalysis, and renal ultrasound examination for evaluation. Success was defined as symptomatic and radiologic relieve. Lastly, a literature search was conducted to review all published articles regarding RAUN surgery in adults. ResultsThe patients’ mean age, BMI, EBL, operative time, and follow-up period were 45.4 years, 23.1 kg/m2, 65.6 mL, 182.9 min, and 21.3 months, respectively. The two most common indications for the surgery were benign ureteral strictures and ureteric injuries secondary to a previous radical hysterectomy. Of the 34 cases, 26 (76.5%) and 8 (23.5%) patients received primary RAUN and RAUN with psoas hitch technique, respectively. Refluxing RAUN method was performed in all cases. No intraoperative complications were found. Two patients had a radiologic and symptomatic recurrence; one was managed with a repeat surgery while the other received ureteral dilatation treatment. ConclusionBoth our study and the published literature showed that RAUN is a safe, less invasive, and effective surgical technique that can easily replicate the open ureteroneocystostomy for managing lower ureteral diseases.

Minimally Invasive UV Fistula Repair with the Aid of Laparoscopic Ureteroneocystostomy

Video Objective We will present two cases which suffered from ureteral vaginal fistula after hysterectomy and underwent repair at our institute. Setting Urban general hospital Japan. Interventions Case 1 complained of fluid leakage two days after laparoscopic hysterectomy. CT showed leakage of urine from the lower ureter. Case 2 was referred to us from another institute after suffering from vaginal fluid leakage for four years. This case underwent abdominal hysterectomy four years ago and two weeks later the patient complained of fluid leakage. Six months later, an urologist made an attempt to repair the fistula but was unsuccessful due to the amount of adhesion the patient was suffering. For Case 1, we performed a laparoscopic uteroneocystostomy with a psoas hitch, which facilitated a tension-free anastomosis for this patient. The most important point of this surgery is meticulous dissection without impairing blood perfusion. This was extremely difficult in Case 2 due to extensive and severe adhesion. Laparoscopic skills for this reconstruction such as laparoscopic suturing and knowledge of fundamentals like tension and torsion free anastomosis are vital for the success of the surgery. No patients experienced stenosis or leaks and no other complications occurred and no blood transfusions were required. The fistulas were repaired without sequel. The patients were able to ambulate and take a normal diet the day after the surgery and could be discharged 4 days after surgery. Conclusion Although knowledge of reconstruction and laparoscopic skills such as intracorporeal suturing and ligation are difficult to master, this technique is valuable in its feasibility and patient friendliness.

Total Laparoscopic Ureteroneocystostomy for Ureteral Endometriosis: A Single-Center Experience of 160 Consecutive Patients

Study ObjectiveTo investigate the efficacy of laparoscopic ureteroneocystostomy in patients with deep infiltrating endometriosis (DIE) with ureteral, parametrial, and bowel involvement. DesignProspective study (Canadian Task Force classification II-2). SettingTertiary referral center for endometriosis care. PatientsOne hundred sixty patients with DIE underwent laparoscopic radical eradication and ureteroneocystostomy between January 2009 and December 2016. InterventionsLaparoscopic nerve-sparing radical treatment with ureteroneocystostomy, parametrectomy, and, if necessary, segmental bowel resection. Measurements and Main ResultsSurgical eradication was radical, and ureteral endometriosis was histologically confirmed in all patients (45.6% intrinsic and 54.4% extrinsic). In 58.7% of patients ureteroneocystostomy was performed with the psoas hitch technique. Bowel resection was performed in 121 patients (75.6%), and 115 of them had a concomitant ileostomy (71.9%). Unilateral parametrectomy was performed on the left side in 61.9% of patients and on the right side in 30% of patients, respectively, whereas bilateral parametrectomy was completed in 33 patients (20.6%). Postoperative complications were infrequent: 7 patients underwent reoperation (4.4%), 8 patients experienced fever (5%), 4 patients required blood transfusion (2.5%), 3 patients had intestinal fistulas (1.9%), and 24 patients experienced impaired bladder voiding (15%) after 6 months. Mean follow-up time was 20.5 months (range, 1–60). The study reported good clinical and surgical results, with a regression of symptoms (p < .001) and recurrence of parametrial endometriosis of 1.2% that required opposite-side ureteroneocystostomy. ConclusionThis is the largest documented series of patients with DIE undergoing laparoscopic radical eradication and ureteroneocystostomy. The collected data show that in patients with ureteral endometriosis, this technique is feasible, effective, and safe and provides good results in terms of relapses and symptoms' control.

Laparoscopic ureteroneocystostomy for mid and lower ureteric strictures: Experience from a tertiary center.

Purpose:The purpose of this study is to evaluate our experience of laparoscopic ureteroneocystostomy for mid and lower ureteral stricture in a tertiary center in North India.Materials and Methods:A total of 20 laparoscopic ureteroneocystostomy were performed with or without bladder flap procedures in 20 patients (13 females and 7 males) with various etiologies such as ureteric stricture, ureterovaginal fistula, endometriosis, and distal ureteric tumor at our hospital in a time frame from August 2013 to January 2017. Eight cases each presented after laparoscopic/open hysterectomy and postureterorenoscopic stone removal while two cases each presented secondary to endometriosis and distal ureteric tumor. Simple laparoscopic ureteroneocystostomy in 4, psoas hitch in 9, and Boari flap was done in 7 cases.Results:The mean patient age was 44.2 years (range 19–65), mean surgical time was 184.25 min (115–250 min.), mean amount of bleeding was 153.25 mL (90–250 mL), and mean hospital stay was 3.05 days (2–7 days). Female-to-male ratio was 1.3:0.7. There was one conversion to open during laparoscopic Boari reimplant because of inadvertent injury to external iliac vein. The mean follow-up was 22.35 months (6–45). All the patients were asymptomatic with the resolution of hydronephrosis on ultrasound and without any significant obstruction on renal scan.Conclusions:Laparoscopic ureteroneocystostomy with or without bladder flap (Boari) provides good functional outcomes with excellent success rates and minimal morbidity comparable to open surgery in patients with ureteric stricture.

Laparoscopic Ureteroneocystostomy with a Vesicopsoas Hitch in 10 Steps

Study ObjectiveLaparoscopic ureteroneocystostomy with a vesicopsoas hitch has the advantages of a minimally invasive approach. The standardization and description of the technique are the main objectives of this video. We described this procedure in 10 steps, which could help to understand and perform this procedure. MethodsThis video presents an approach to laparoscopic ureteroneocystostomy with a vesicopsoas hitch, which was clearly divided into 10 steps. The local institutional review board was consulted and ruled that approval was not required for this video article because the video describes a technique and does not report a clinical case. The patient cannot be identified, and she gave informed consent. ResultsThe 10 steps are as follows: step 1, identification of the healthy ureter; step 2, identification of the stenotic part; step 3, section of the ureter; step 4, bladder mobilization; step 5, anterior cystostomy; step 6, psoas hitch; step 7, closure of the anterior cystostomy; step 8, posterior spatulation of the ureter; step 9, cystostomy of the superolateral bladder dome; and step 10, ureteral suture to the bladder. ConclusionLaparoscopic ureteroneocystostomy with a vesicopsoas hitch is an effective technique for intrinsic ureteral endometriosis; it usually needs ureteral resection with end-to-end reanastomosis or reimplantation if the anastomosis is in tension. The 10 steps help to perform each part of surgery in logical sequence, making the procedure faster to adopt and learn. The standardization of laparoscopic techniques could help to reduce the learning curve.

219 - Laparoscopic Ureteroneocystostomy Following UV Fistula in Ectopic Kidney

Ureteroneocystostomy with contralateral psoas hitch was performed in an operated case of Total Laparoscopic Hysterectomy with Left Ectopic Pelvic Kidney in a patient presenting with Uretero-Vaginal Fistula.

310 - Laparoscopic Ureteroneocystostomy for Ureteral Endometriosis

Endometriosis is a common disease associated with chronic pelvic pain and infertility. For ureteral endometriosis, which is rare, conventional therapy previously consisted of laparotomy. However, laparoscopic ureteroneocystostomy has been reported recently. Laparoscopic surgery for ureteral endometriosis requires greater surgical expertise and takes a longer time to master. The minimally invasive approach is well known to give patients benefits because of its small incision, less pain and shorter hospital stay. We performed ureteroneocystostomy for 17 patients between January 2008 and December 2016.

57 - Total Laparoscopic Ureteroneocystostomy for Ureteral Endometriosis: A Single Center Experience on 160 Consecutive Cases

Study Objective: To investigate the efficacy of laparoscopic ureteroneocystostomy in patients with deep infiltrating endometriosis (DIE) with ureteral and parametrial involvement.