Laparoscopic Ureterolysis and Omental Wrapping

Giuseppe Simone, Costantino Leonardo, Rocco Papalia, Salvatore Guaglianone, Michele Gallucci

Research output: Contribution to journalArticle

Abstract

Objectives: To describe our laparoscopic technique of ureterolysis and omental wrapping using the LigaSure device for the treatment of idiopathic retroperitoneal fibrosis. Methods: Four bilateral laparoscopic ureterolyses (LUs) and two unilateral LUs were performed in 6 male patients (mean age 47 years). Of the 6 patients, 4 underwent LU without having undergone medical therapy before surgery and 2 underwent LU after medical therapy failure. All had had ureteral stents placed before surgery. The ureters were completely freed from the fibrotic tissue using an Overholt laparoscopic forceps and 10-mm LigaSure atlas. An omental wrap was passed behind the colonic flexure, placed around the ureter, and fixed to the psoas muscle. Results: The mean operating time was 80 minutes (range 75 and 85) for the unilateral LUs and 200 minutes (range 180-225) for the bilateral procedures. The mean blood loss was 75 mL (range 50 and 100) during LUs and 150 mL (range 80-220) during bilateral LUs. The mean hospital stay was 3.33 days (range 2-5). All indwelling ureteral stents were removed at 4 weeks postoperatively. At a mean follow-up of 37.5 months (range 23-59), all patients were free of symptom and all renal units were unobstructed. Conclusions: In our experience of LUs and omental wrapping, the reproduction of each step of open surgery seems to offer excellent midterm outcomes. The use of the LigaSure simplified the laparoscopic procedure and made it feasible and safe. We believe that the minimally invasive nature and high effectiveness of LU suggest consideration of this procedure as first-line treatment of idiopathic retroperitoneal fibrosis.

Original languageEnglish
Pages (from-to)853-858
Number of pages6
JournalUrology
Volume72
Issue number4
DOIs
Publication statusPublished - Oct 2008

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Retroperitoneal Fibrosis
Ureter
Stents
Psoas Muscles
Atlases
Therapeutics
Surgical Instruments
Reproduction
Length of Stay
Kidney
Equipment and Supplies

ASJC Scopus subject areas

  • Urology

Cite this

Laparoscopic Ureterolysis and Omental Wrapping. / Simone, Giuseppe; Leonardo, Costantino; Papalia, Rocco; Guaglianone, Salvatore; Gallucci, Michele.

In: Urology, Vol. 72, No. 4, 10.2008, p. 853-858.

Research output: Contribution to journalArticle

Simone, G, Leonardo, C, Papalia, R, Guaglianone, S & Gallucci, M 2008, 'Laparoscopic Ureterolysis and Omental Wrapping', Urology, vol. 72, no. 4, pp. 853-858. https://doi.org/10.1016/j.urology.2008.06.011
Simone, Giuseppe ; Leonardo, Costantino ; Papalia, Rocco ; Guaglianone, Salvatore ; Gallucci, Michele. / Laparoscopic Ureterolysis and Omental Wrapping. In: Urology. 2008 ; Vol. 72, No. 4. pp. 853-858.
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