title: Laparoscopic ureteroneocystostomy with psoas hitch.
abstract: OBJECTIVE
  Laparoscopic extravesical ureteroneocystostomy is an infrequently described technique. Our aim is to describe five cases where we used the intracorporeal freehand suturing technique successfully for performing laparoscopic extravesical transperitoneal ureteral reimplantation with psoas hitch. We describe the preliminary results of these cases.
  
  
  METHODS
  We performed this surgery in five female patients. Two patients had a low ureterovaginal fistula after total laparoscopic hysterectomy. The other three patients had undergone laparoscopic radical hysterectomy.
  
  
  RESULTS
  The average surgical time was 220 minutes. The average blood loss was 150 mL. The average stay was 3 days, and the average time to starting oral intake was 12 hours. No intraoperative or postoperative complications occurred. The urinary catheter was removed after 3 weeks and the double j stent after 6 weeks. Follow-up urography showed good clearance of the kidney and ureter. There was no reflux on the postoperative cystogram.
  
  
  CONCLUSIONS
  Laparoscopic extravesical ureteroneocystostomy with intracorporeal freehand suturing technique and psoas hitch is a feasible procedure in females for managing ureterovaginal fistulas after laparoscopic gynecologic surgeries. The patients need not be subjected to open surgery because this complication can be repaired laparoscopically, thus minimizing the morbidity.
authors.affiliation: Galaxy Laparoscopy Institute Pune, Maharahstra, India.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Puntambekar
authors.forename: Reshma J
authors.initials: RJ
authors.lastname: Palep
authors.forename: Ajit M
authors.initials: AM
authors.lastname: Gurjar
authors.forename: Ravindra M
authors.initials: RM
authors.lastname: Sathe
authors.forename: Amol G
authors.initials: AG
authors.lastname: Talaulikar
authors.forename: Geetanjali A
authors.initials: GA
authors.lastname: Agarwal
authors.forename: Madhuri
authors.initials: M
authors.lastname: Kashyap
mesh_terms: D000714:Anastomosis, Surgical; D003559:Cystostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D010535:Laparoscopy; D008875:Middle Aged; D013536:Suture Techniques; D014513:Ureter / Q000601:surgery*; D014515:Ureteral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*; D014624:Vaginal Fistula / Q000209:etiology / Q000601:surgery*