Urinary tract reconstruction using the controlateral native ureter and a combined open-retroperitoneoscopic approach after renal transplantation

Giuseppe Orlando, Luigi Di Clemente, Gianpiero Gravante, John Overton, Pierpaolo Di Cocco, Vinicio Rizza, Maurizio D'angelo, Antonio Famulari, Francesco Pisani

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

An alternative technique for urinary tract (UT) reconstruction is described in a renal transplant recipient who developed a severe stenosis of the graft ureter. This approach entails the retroperitoneoscopic preparation of the native ureter contralateral to the graft, followed by an open reconstruction of the UT. The ureter was dissected along its entire length to the level of the iliac vessels, with its associated mesentery still attached in order to preserve the vascular supply. The corresponding native kidney contralateral to the graft was endoscopically removed. A longitudinal sub-umbilical incision allowed the excision of the stenotic tract and the reconstruction of the UT by means of a manual end-to-end anastomosis between the new ureter and the graft pelvis. No post-operative complications occurred and renal function immediately resumed. The approach described represents an alternative solution for the surgical management of severe ureteric graft stenosis. We believe that the magnification of the anatomy granted by the endoscope during the dissection of the ureter and neighboring structures provides the gentle handling of the tissues and the remote dissection away from the ureter with the highest precision.

Original languageEnglish
Pages (from-to)842-846
Number of pages5
JournalClinical Transplantation
Volume22
Issue number6
DOIs
Publication statusPublished - 2008

Fingerprint

Ureter
Urinary Tract
Kidney Transplantation
Transplants
Kidney
Dissection
Pathologic Constriction
Umbilicus
Mesentery
Endoscopes
Pelvis
Blood Vessels
Anatomy

Keywords

  • Blood supply
  • Ischemia
  • Renal transplantation
  • Retroperitoneoscopy
  • RT, renal transplantation
  • Stenosis
  • Ureter
  • Urinary tract complication Abbreviations: Cr, serum creatinine
  • US, ureteral stricture
  • UT, Urinary tract

ASJC Scopus subject areas

  • Transplantation

Cite this

Urinary tract reconstruction using the controlateral native ureter and a combined open-retroperitoneoscopic approach after renal transplantation. / Orlando, Giuseppe; Di Clemente, Luigi; Gravante, Gianpiero; Overton, John; Di Cocco, Pierpaolo; Rizza, Vinicio; D'angelo, Maurizio; Famulari, Antonio; Pisani, Francesco.

In: Clinical Transplantation, Vol. 22, No. 6, 2008, p. 842-846.

Research output: Contribution to journalArticle

Orlando, Giuseppe ; Di Clemente, Luigi ; Gravante, Gianpiero ; Overton, John ; Di Cocco, Pierpaolo ; Rizza, Vinicio ; D'angelo, Maurizio ; Famulari, Antonio ; Pisani, Francesco. / Urinary tract reconstruction using the controlateral native ureter and a combined open-retroperitoneoscopic approach after renal transplantation. In: Clinical Transplantation. 2008 ; Vol. 22, No. 6. pp. 842-846.
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