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Bilateral laparoscopic ureterolysis using hydrodissection in retroperitoneal fibrosis: a new application of an old technique.
Res Rep Urol 2019; 11:131-135RR

Abstract

Objective:

To describe our new laparoscopic approach in ureterolysis using the ERBEJET® 2 device to hydrodissect the ureters in idiopathic retroperitoneal fibrosis.

Methods:

Bilateral laparoscopic ureterolysis was done after medical therapy failure (steroids) in a 47 year old patient with retroperitoneal fibrosis. Ureteral stents were placed before surgery. Only five trocars were used for both sides, Toldt's fascia was opened and the dissection was performed till the psoas muscle. The ureters were completely freed from the fibrotic tissue using the ERBEJET 2 device (pure hydrodissection). An omental wrap was passed behind the colonic flexure at the right and placed around the ureter. At the left, we closed Toldt's fascia by running sutures back to the freed ureter.

Results:

The operating time was 198 mins. The blood loss was 50 cc. The hospital stay was 3 days. The double J stents were removed at 4 weeks postoperatively. After 2 years, the patient is free of symptoms with normal creatinine level and no urinary tract obstructions.

Conclusions:

Hydrodissection of the ureter in retroperitoneal fibrosis is a new application in the upper urinary tract laparoscopic approach that has not been described in literature before. It seems to offer excellent midterm outcomes. The use of ERBEJET 2 device seems to simplify the procedure and make it feasible and safe (less trauma to the ureter and more conservation of its blood supply). We believe that comparative studies are needed to assess the role of hydrodissection in ureterolysis for retroperitoneal fibrosis.

Authors+Show Affiliations

Urology Department, Centre Hospitalier Régional René DUBOS, Pontoise, 95300, France.Anesthesia Department, Institut Gustave Roussy, Villejuif, 94550, France.Urology Department, Notre Dame Des Secours University Medical Center, Byblos, Lebanon.Urology Department, Notre Dame Des Secours University Medical Center, Byblos, Lebanon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31119118

Citation

Abdessater, Maher, et al. "Bilateral Laparoscopic Ureterolysis Using Hydrodissection in Retroperitoneal Fibrosis: a New Application of an Old Technique." Research and Reports in Urology, vol. 11, 2019, pp. 131-135.
Abdessater M, Elias S, Boustany J, et al. Bilateral laparoscopic ureterolysis using hydrodissection in retroperitoneal fibrosis: a new application of an old technique. Res Rep Urol. 2019;11:131-135.
Abdessater, M., Elias, S., Boustany, J., & El Khoury, R. (2019). Bilateral laparoscopic ureterolysis using hydrodissection in retroperitoneal fibrosis: a new application of an old technique. Research and Reports in Urology, 11, pp. 131-135. doi:10.2147/RRU.S201396.
Abdessater M, et al. Bilateral Laparoscopic Ureterolysis Using Hydrodissection in Retroperitoneal Fibrosis: a New Application of an Old Technique. Res Rep Urol. 2019;11:131-135. PubMed PMID: 31119118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral laparoscopic ureterolysis using hydrodissection in retroperitoneal fibrosis: a new application of an old technique. AU - Abdessater,Maher, AU - Elias,Sandra, AU - Boustany,Johnny, AU - El Khoury,Raghid, Y1 - 2019/05/01/ PY - 2019/01/13/received PY - 2019/03/05/accepted PY - 2019/5/24/entrez PY - 2019/5/24/pubmed PY - 2019/5/24/medline KW - hydrodissection KW - laparoscopic ureterolysis KW - new technique KW - retroperitoneal fibrosis SP - 131 EP - 135 JF - Research and reports in urology JO - Res Rep Urol VL - 11 N2 - Objective: To describe our new laparoscopic approach in ureterolysis using the ERBEJET® 2 device to hydrodissect the ureters in idiopathic retroperitoneal fibrosis. Methods: Bilateral laparoscopic ureterolysis was done after medical therapy failure (steroids) in a 47 year old patient with retroperitoneal fibrosis. Ureteral stents were placed before surgery. Only five trocars were used for both sides, Toldt's fascia was opened and the dissection was performed till the psoas muscle. The ureters were completely freed from the fibrotic tissue using the ERBEJET 2 device (pure hydrodissection). An omental wrap was passed behind the colonic flexure at the right and placed around the ureter. At the left, we closed Toldt's fascia by running sutures back to the freed ureter. Results: The operating time was 198 mins. The blood loss was 50 cc. The hospital stay was 3 days. The double J stents were removed at 4 weeks postoperatively. After 2 years, the patient is free of symptoms with normal creatinine level and no urinary tract obstructions. Conclusions: Hydrodissection of the ureter in retroperitoneal fibrosis is a new application in the upper urinary tract laparoscopic approach that has not been described in literature before. It seems to offer excellent midterm outcomes. The use of ERBEJET 2 device seems to simplify the procedure and make it feasible and safe (less trauma to the ureter and more conservation of its blood supply). We believe that comparative studies are needed to assess the role of hydrodissection in ureterolysis for retroperitoneal fibrosis. SN - 2253-2447 UR - https://www.unboundmedicine.com/medline/citation/31119118/Bilateral_laparoscopic_ureterolysis_using_hydrodissection_in_retroperitoneal_fibrosis:_a_new_application_of_an_old_technique L2 - https://dx.doi.org/10.2147/RRU.S201396 DB - PRIME DP - Unbound Medicine ER -