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. 2019 Jan;14(1):102-106.
doi: 10.5114/wiitm.2018.77260. Epub 2018 Jul 23.

Antegrade stent placement in laparoscopic upper urinary tract surgery. Is there an easy way?

Kaan Gökçen  1 , Gökhan Gökçe  1 , Yakup Kordan  2 , Emre Kıraç  1 , Gökçe Dündar  3 , Emin Yener Gültekin  1
Affiliations

Antegrade stent placement in laparoscopic upper urinary tract surgery. Is there an easy way?

Kaan Gökçen et al. Wideochir Inne Tech Maloinwazyjne. 2019 Jan.

Abstract

Introduction: Antegrade placement of double J stents in laparoscopy is considered a challenging and time-consuming process due to limitations regarding stent flexibility.

Aim: To describe the method we used to facilitate the antegrade placement of intracorporeal stents in laparoscopic upper urinary tract (LUUT) surgery and report its results.

Material and methods: Data obtained from 42 consecutive patients who had stents placed antegradely in laparoscopic pyeloplasty or in laparoscopic ureterolithotomy for middle-upper ureteral stones were retrospectively evaluated. The mean age of the patients was 30.1 ±18.6 (10 months-68 years) and 13 patients were in the paediatric age group. All patients in the paediatric age group underwent laparoscopic pyeloplasty.

Results: The mean operative time for the 42 total cases, of which 32 underwent laparoscopic dismembered pyeloplasty and 10 laparoscopic ureterolithotomy, was 126.9 ±33.5 (70-200) min and the intraoperative stent placement time was calculated as 2.61 ±0.8 (1.5-5) min. The patients, who had a mean hospitalization time of 2.8 ±0.9 (2-5) months, required no additional interventions and no complications were encountered intraoperatively. In the patient series that had a mean follow-up time of 17.4 ±11.3 (1-35), it was determined only in 1 patient that the distal tip of the stent had not been in the bladder.

Conclusions: The described modified antegrade stent placement technique is a practical method that is safe for all LUUT cases in both paediatric and adult age groups and it has been shown to produce successful outcomes and to be time-saving.

Keywords: laparoscopy; pelviureteral anastomoses; pyeloplasty; stenting; upper ureteral stones.

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Figures

Photo 1
Photo 1
Preoperative preparation of the D/J stent to be inserted through a suitable Amplatz dilator and its intracorporeal antegrade placement
See this image and copyright information in PMC

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