Modified Single-Sided Laparoscopic Extravesical Antireflux Operation

Introduction. Laparoscopic techniques have been applied to ensure surgical treatment of the vesicoureteral reflux (VUR) in children during the last decades. We present the experience of using the laparoscopic extravesical antireflux standard and ureter-fixed modified surgery. Materials and methods. A multi-center prospective experimental clinical historical cohort two-group study of patients with III–V stage primary VUR. The basic group consisted of 48 children who had a unilateral laparoscopic extravesical surgery when the ureter was fixed according to the developed technique. 44 children who had a surgery according to the standard technique were included into the control group. Results. Complete VUR removal was noted in 100% of patients from the basic group and 81.2% of patients from the control group (р <0.01). Preservation of the megaureter with complete reflux resolution was seen in 1 child only (2.1%) from the basic group who had V stage VUR (p=0.2). Conclusions. Laparoscopic extravesical antireflux is a safe and effective surgery. Distal ureter fixation reduces the rate of VUR recurrences.