Preliminary experience with ureteral intussusception in exclusive retroperitoneoscopic nephroureterectomy: a simple and safe option for the resection of the distal ureter and bladder cuff.
OBJECTIVE
To describe a surgical option in the resection of the distal third of the ureter and bladder cuff.


METHODS
Three nephroureterectomies were performed by the extraperitoneal access. The first was performed in a patient with vesicoureteral reflux, recurrent urinary infection and chronic renal failure; and two nephroureterectomies were performed for the treatment of upper urinary tract transitional cell cancer.


RESULTS
Nephrectomy, according to the technique described by Gill, and treatment of the distal ureter were done based on the principles of open surgery, with exposure of the kidney by enlargement of one of the portals, sectioning the ureter, insertion of a catheter in the ureter antegradely of and eversion of the ureter endoscopically, followed by the removal of the bladder cuff.


CONCLUSIONS
Among the techniques utilized for this procedure, we believe that the technique described herein presents some advantages because it does not require an incision for the removal of the distal ureter, it is easy to perform and provides more comfort to the patient after the surgery. Furthermore, only materials used by the urologist in routine practice are required and there is no contamination of the surgical space by neoplastic cells.
Tobias-Machado
Marcos
M
Department of Urology, Facultade de Medicina do ABC, São Paulo, Brazil. dmalvesp@terra.com.br
Pinto
Marcello Alves
MA
Juliano
Roberto Vaz
RV
Fugante
Paulo Emilio
PE
Wroclawski
Eric Roger
ER
Borrelli
Milton
M
D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D006801:Humans; D009392:Nephrectomy / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D012449:Safety; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization; D014718:Vesico-Ureteral Reflux / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000379:methods*