Laparoscopic ureterolysis with omental wrap for idiopathic retroperitoneal fibrosis

Robert J. Stein, Neil S. Patel, Kyle Quinn, Milton Berger, Walter Koff, Gaurang Shah, Monish Aron, Andre K. Berger

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

OBJECTIVE To describe various approaches for ureterolysis with an omental wrap using minimally invasive techniques, as surgery for idiopathic retroperitoneal fibrosis includes tissue biopsy, ureterolysis, and intraperitonealization or omental wrap. PATIENTS AND METHODS Since 2006 we have performed ureterolysis in four patients diagnosed with retroperitoneal fibrosis in two institutions. The ureterolysis in two cases was bilateral, using a standard laparoscopic approach for one case and a hand-assisted technique for the other. Unilateral ureterolysis was completed using a standard laparoscopic approach in one case and was converted to a hand-assisted technique in the other due to difficulty with ureteric identification. An omental wrap was used after ureterolysis for all renal units. RESULTS A minimally invasive technique was used for all ureterolysis procedures and none required open conversion. There was fascial dehiscence after surgery at the hand-port site in one patient, and required re-operation for wound closure. The median (range) hospital stay for all patients was 2.5 (2-10) days and the median blood loss was 100 (50-550) mL. No patient required a blood transfusion. At a median 16.5 (12-32) months of follow-up, there was symptomatic and radiographic success in all patients. CONCLUSIONS Ureterolysis can be a challenging operation depending on the extent of the retroperitoneal mass. An understanding of various laparoscopic techniques can provide the flexibility for successful completion of nearly all of these procedures using a minimally invasive approach.

Original languageEnglish (US)
Pages (from-to)703-707
Number of pages5
JournalBJU International
Volume106
Issue number5
DOIs
StatePublished - Sep 1 2010

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Keywords

  • hydronephrosis
  • laparoscopic
  • omental wrap
  • retroperitoneal fibrosis
  • ureter
  • ureterolysis

ASJC Scopus subject areas

  • Urology

Cite this

Stein, R. J., Patel, N. S., Quinn, K., Berger, M., Koff, W., Shah, G., Aron, M., & Berger, A. K. (2010). Laparoscopic ureterolysis with omental wrap for idiopathic retroperitoneal fibrosis. BJU International, 106(5), 703-707. https://doi.org/10.1111/j.1464-410X.2009.09186.x