[The ureteric risk in laparoscopic surgery].
OBJECTIVE
To describe the circumstances of development, diagnostic approach and treatment of iatrogenic ureteric lesions after laparoscopic surgery.


METHODS
From 1992 to 2003, nine patients with iatrogenic trauma of the ureter after laparoscopic surgery were managed by our team.


RESULTS
The time to diagnosis ranged from 0 to 640 days. These injuries were related to gynaecological surgery in 56% of cases, gastrointestinal surgery in 22% of cases, vascular surgery in 11% of cases, and spinal surgery in 11% of cases. The two lesions identified intraoperatively were treated immediately with success. In the case of lesions identified secondarily, first-line endourological treatment was performed in 57% of cases with a good result without reoperation in only 25% of cases. Three patients required reoperation with 66% of satisfactory results and two patients were treated by nephrectomy.


CONCLUSIONS
Intraoperative difficulties and limited experience of laparoscopic surgery are the factors most frequently identified in iatrogenic ureteric lesions. The time to diagnosis has a considerable impact on the modalities and results of management.
Adhoute
Frédéric
F
Service d'Urologie, CHU Pellegrin, Bordeaux, France.
Pariente
Jean-Louis
JL
Le Guillou
Michel
M
Ferrière
Jean-Marie
JM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014513:Ureter / Q000293:injuries*; D018666:Ureteroscopy