Abstract

Background: The retrocaval ureter is a congenital abnormality in
which the right ureter passes behind the inferior vena cava, leading
to varying degrees of ureteral compression. Surgery is required for
the treatment of the hydronephrosis or related symptoms. The
video shows ‘‘step by step’’ a transperitoneal laparoscopic transection
of a retrocaval ureter with transposition and reanastomosis.
Methods: A 14 years-old girl presented to our institution with right
lumbar pain and hydronephrosis. The CT showed a retrocaval
ureter. We performed a transperitoneal laparoscopic transection of
the retrocaval ureter with transposition and reanastomosis with 2
uninterrupted absorbable sutures (Vicryl 3.0). A mono-J ureteral
stent (Contour VLTM Variable Length Percuflex, Boston Scientific)
is placed just before starting the laparoscopic approach.
Results: Operative time was 260 minutes, blood losses were negligible;
on postoperative day 3 after a retrograde pyelography excluded
contrast medium extravasation and the Contour stent was
converted in a double J stent. Bladder catheter and the drain were
respectively removed on postoperative day IV and V. The patient
had no perioperative complications and was discharged on postoperative
day IX. The ureteral stent was removed 28 days after
surgery. The urography at 3 months showed regular patency of the
anastomosis.
Conclusion: The transperitoneal laparoscopic correction of the
right retrocaval ureter is a feasible and minimally invasive.