Laparoscopically assisted ureterocystoplasty

The concept of ureterocystoplasty, in this case laparoscopically assisted, is addressed by several authors from the USA. The details of their technique are described, and avoiding a large midline incision was found to be particularly beneficial to the patient. Authors from Paris and Toronto describe a further laparoscopic study. They describe a trial comparing the retroperitoneal approach to open partial nephrectomy. These authors also feel that the laparoscopic approach to surgery, in this case partial nephrectomy, is safe and feasible in children, with no increase in operative duration and a shorter hospital stay. Objective To assess the efficacy and safety of laparoscopically assisted ureterocystoplasty (LAU) in children. Patients and methods From 1999 to 2001, five patients (mean age 7 years, range 3.5–13) from four centres underwent LAU with laparoscopic mobilization of the small kidney and upper ureter combined with ureterocystoplasty, with exposure of the bladder through a Pfannenstiel incision. The details and outcomes are reviewed. Results The LAU was successful in all five patients; there were no complications. A large midline incision was avoided and the LAU carried out through the better tolerated and less painful Pfannenstiel incision. Conclusion LAU is an appealing technique that is safe with the added benefit of a reduced abdominal incision and acceptable operative duration. This represents the first published report of LAU.