Dinesh K Agarwal1. 1. Urology Unit, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: Management of the distal ureter during radical nephroureterectomy remains a controversial issue. This article describes a simple endoscopic PolyLoop ligation technique for managing the distal ureter during radical nephroureterectomy. TECHNIQUE: This endoscopic technique was used in 6 cases to manage the distal ureter during laparoscopic-assisted radical nephroureterectomy. The distal ureter with en bloc bladder cuff was managed endoscopically. The distal ureteric orifice with 1 cm bladder cuff was circumscribed using a Collins knife. Commercially available, Olympus detachable PolyLoop was used to ligate the ureteric stump to avoid urine spillage from the upper tract. Once ureteric stump was ligated with a PolyLoop, the distal ureter was mobilized by dividing the periureteric adhesions using a Collins knife. RESULTS: Distal ureter was managed successfully in all 6 cases using commercially available detachable Polyloop from Olympus. There were no perioperative complications relating to this technique. CONCLUSION: The PolyLoop ligation technique offers a simple and safer alternative to manage the distal ureter during radical nephroureterectomy.
OBJECTIVE: Management of the distal ureter during radical nephroureterectomy remains a controversial issue. This article describes a simple endoscopic PolyLoop ligation technique for managing the distal ureter during radical nephroureterectomy. TECHNIQUE: This endoscopic technique was used in 6 cases to manage the distal ureter during laparoscopic-assisted radical nephroureterectomy. The distal ureter with en bloc bladder cuff was managed endoscopically. The distal ureteric orifice with 1 cm bladder cuff was circumscribed using a Collins knife. Commercially available, Olympus detachable PolyLoop was used to ligate the ureteric stump to avoid urine spillage from the upper tract. Once ureteric stump was ligated with a PolyLoop, the distal ureter was mobilized by dividing the periureteric adhesions using a Collins knife. RESULTS: Distal ureter was managed successfully in all 6 cases using commercially available detachable Polyloop from Olympus. There were no perioperative complications relating to this technique. CONCLUSION: The PolyLoop ligation technique offers a simple and safer alternative to manage the distal ureter during radical nephroureterectomy.
Authors: Morgan Rouprêt; Marko Babjuk; Eva Compérat; Richard Zigeuner; Richard Sylvester; Max Burger; Nigel Cowan; Andreas Böhle; Bas W G Van Rhijn; Eero Kaasinen; Joan Palou; Shahrokh F Shariat Journal: Eur Urol Date: 2013-03-19 Impact factor: 20.096
Authors: Chad R Ritch; Jamie T Kearns; Adam C Mues; Gregory W Hruby; Mitchell C Benson; James M McKiernan; Jaime Landman Journal: J Endourol Date: 2011-06-20 Impact factor: 2.942