Laparo-endoscopic single-site surgery combined with extracorporeal ureteral trimming technique in ureteral bladder reimplantation

Li Jianxiong; Yang Cheng; He Kang; Xia Ming; Luo Xingui; Liu Cundong

doi:10.19558/j.cnki.10-1020/r.2024.01.007

Abstract：Objective:To explore the feasibility of transumbilical laparo-endoscopic single site surgery(LESS)combined with extracorporeal trimming technique in the treatment of distal ureteral obstruction.Methods:Case data of 23 patients admitted to the Third Affiliated Hospital of Southern Medical University from March 2020 to March 2023 who underwent ureteral reimplantation for ureteral end-stage obstruction were retrospectively analyzed.All of them were operated in the reclined lithotomy position,and the operation was performed with an umbilical incision of about 3 cm,placing a four-channel single-hole puncture kit for placing laparoscopic observation holes and operation holes,which allowed dislodging of ureteral severed ends outside the body for fine trimming,and placing a double J-tube under direct visualization,and recording the relevant surgical indexes,postoperative complications,patient satis-faction,and other clinical data.Results:All patients successfully completed the surgery without adding auxiliary holes or changing to open surgery.The operation time was(128.48±47.85)min,the postoperative hospitalization days was(9.61±7.29)d.No intraoperative luminal drainage tube was left in the operation,and there were no compli-cations such as postoperative hemorrhage,anastomotic fistula,and abdominal infection;the surgical incision was beautiful,and the patient satisfaction was good.Conclusion:Under the premise of strictly grasping the indications,laparo-endoscopic single site surgery combined with extracorporeal trimming technique for the treatment of distal ure-teral obstruction is safe and feasible,and has the advantages of fast postoperative recovery and good cosmetic effect,which is worthy of promotion.