Laparoscopic ipsilateral ureteroureterostomy in the management of ureteral ectopia in infants and children

Objective: We report our initial experience, and describe our technique, in performing laparoscopic ipsilateral ureteroureterostomy (IUU) in the pediatric population. Materials and methods: An IRB-approved, retrospective review of all patients undergoing laparoscopic IUU at our institution between 2006 and 2009 was performed. Demographic data, mode of presentation, underlying diagnosis, operative parameters, complications and follow-up data were analyzed. Cystoscopy, retrograde pyelograms and ureteral stent placement into the lower pole ureter were performed at the beginning of all cases. All were performed via a transperitoneal approach. An end-to-side ureteral anastamosis was carried out along the proximal lower pole ureter. No drains were left in place. Urethral catheters were left for 48 h. Results: There were seven patients in the series. All were female with a mean age of 84 months (11(sic)190). Diagnosis was an ectopic ureter in six patients and a ureterocele in one patient. No patient required conversion to an open approach. Mean total operative time was 187 min (140(sic)252). Mean hospital stay was 2 days (1(sic)4) with a mean follow up of 8 months (1(sic)15). No complications occurred postoperatively. Follow-up studies demonstrate decreased or resolved hydronephrosis in all cases. Conclusions: In our initial experience, laparoscopic IUU can be accomplished in a safe and effective manner with minimal complication. Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company.