A simple and safe technique for trocar positioning in vesicoscopic ureteric reimplantation

作者：Abraham Mohan K^*; Viswanath Naveen; Bindu S; Kedari Prashanth; Ramakrishnan P; Naaz Aisha; Mohan Sharon

来源：Pediatric Surgery International, 2011, 27(11): 1223-1226.

DOI：10.1007/s00383-011-2966-5

• Vesicoscopic reimplantation
• Transvesical reimplantation
• Vesicoureteric reflux
• Laparoscopic reimplantation
• Cohen's reimplantation

Purpose Anchoring of the urinary bladder to the anterior abdominal wall is essential to prevent perivesical gas leak and dislodgement of trocar. Existing techniques have the risk of going through the peritoneal cavity and injuring the bowel. Our aim was to find a safe technique to anchor the bladder wall to the abdominal wall.
Materials and methods Nineteen cases were studied prospectively. A curved urethral dilator was introduced and made to point on the anterior abdominal wall. Abdominal wall was incised over the tip of the dilator till the bladder was seen which was then sutured to the anterior abdominal wall. The bladder was then incised and the trocars were railroaded on the dilator into the bladder. Cohen's reim-plantation was then done.
Results Out of the 19 cases, conversion to open was done in two early cases. In one case, the trocar got pulled out, but was easily reintroduced. Mean operating time was 210 min. Mean follow up was 20.9 months. There was a resolution of reflux in 13, reduction in the grade of reflux in 1 and no failures. In five cases, post op MCU is awaited.
Conclusion This technique of fixing the bladder to the anterior abdominal wall is safe and easy to perform. It is recommended while doing vesicoscopic reimplantation.

• 出版日期2011-11
• 单位河北医科大学