Laparoscopic transperitoneal ipsilateral ureteroureterostomy with transabdominal suspension technique for ureteral duplication in children: A case series

Introduction Ipsilateral ureteroureterostomy (IUU) preserves renal parenchyma while relieving obstruction in complete ureteral duplication with upper moiety hydroureteronephrosis, and a transabdominal suspension technique may be beneficial in younger children with limited working space. Materials and methods A retrospective review was conducted on nine patients (five boys, four girls) with a median age of 12 months (range 7-65 months) who underwent laparoscopic IUU between January 2023 and October 2024. All presented with complete duplication and viable upper moiety hydroureteronephrosis. A 4-Fr double-J stent was placed in the lower moiety ureter via cystoscopy. We utilized a transperitoneal approach with three trocars (3-mm or 5-mm). A transabdominal suspension technique was employed to stabilize the lower ureter during anastomosis. Results The mean operative time was 110 ± 20.2 min. No intraoperative complications or open conversions occurred. The mean hospital stay was 4 ± 0.7 days. Follow-up ultrasound at a mean of 10.4 months showed reduction in upper moiety pelvic anteroposterior diameter (21.8 ± 7.1 mm vs. 8.8 ± 5.2 mm, p < 0.05) and ureteral diameter (12.3 ± 8.1 mm vs. 8.3 ± 2.7 mm, p < 0.05). All symptoms (urinary tract infections, incontinence) resolved completely. Conclusions Preliminary results suggest that laparoscopic transperitoneal ipsilateral ureteroureterostomy is a feasible and safe minimally invasive option for the morphological preservation of the upper moiety in children. The incorporation of a transabdominal suspension technique facilitates the procedure in limited working space.