Laparoscopic Ureteral Reimplantation underneath Broad Ligament Tunnel for Female Vesicoureteral Stenosis: A Technical Innovation

Abstract

Introduction: In order to anatomically reconstruct ureteral stenosis, we present a novel technique for laparoscopic ureteral reimplantation. Patients and Methods: Three young females, who were diagnosed with hydroureteronephrosis caused by congenital vesicoureteral junction obstruction, were treated by laparoscopic ureteral reimplantation with a tunnel underneath the broad ligament. Results: Surgery was performed successfully without conversion to open surgery. No major intra- or postoperative complications occurred. Postoperative follow-up was 38, 33 and 26 months, respectively. The operative time was between 220 and 260 min. The mean estimated blood loss was less than 20 ml. Subsequent imaging performed 3 months after surgery revealed relief of hydroureteronephrosis for all patients. The patients all gave birth to healthy neonates and showed normal urinary tract sonogram and urine analysis during the gestation period. Conclusion: Laparoscopic ureteral reimplantation with broad ligament tunnel is safe and effective, allowing for anatomical reconstruction of ureter defects. However, a larger clinical sample and longer follow-up period will be needed.