Transureteroureterostomy

The laparoscopic approach to transureteroureterostomy remains in its infancy with no documented clinical case in the literature. This may be due to the fact that there are few indications for a transureteroureterostomy and that there are more attractive alternatives such as bladder flaps or ileal ureteral replacements that would not affect the "contralateral" renal unit. Similarly, in cases of palliative surgery to relieve urinary obstruction, simple percutaneous drainage or a laparoscopic cutaneous diversion is much easier. Nevertheless, Dechet et al. demonstrated that laparoscopic transureteroureterostomy is technically feasible in a porcine model (15). Operative times ranged from 2.5 to 6 hours and eight out of nine procedures were successful. Whether this technique will be applied clinically remains to be seen.

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