title: Laparoscopy-assisted ureter interposition by ileum.
abstract: OBJECTIVE
  To report our experience with the laparoscopic approach to managing ileal ureter substitution for extensive ureteral stenosis.
  
  
  METHODS
  Two patients, one man and one woman, ages 38 and 51 years, respectively, underwent laparoscopic ileal substitution between March 2004 and December 2005 because of extensive ureteral stenosis after stone disease management. A three-port technique was used. The ileal segment was managed extracorporeally through a McBurney incision. Pyeloileal or ileoureteral anastomosis was performed intracorporeally. Follow-up included clinical evaluation, nuclear renography, intravenous urography. and serum chemistry analysis.
  
  
  RESULTS
  There were no complications, and there was minimal blood loss. Mean operative time was 195 minutes (range 180-210 min). Both patients remain without any symptoms or complaints at a median of 18.5 months follow-up (range 8-29 months). Postoperative pyelography verified adequate excretion from the renal unit. Nuclear renography showed no evidence of loss of renal function. No evident variations of preoperative and postoperative serum chemistry values were noted. None of the patients had any complaint or symptoms of urinary-tract infection or urolithiasis.
  
  
  CONCLUSIONS
  The laparoscopic approach appears to be a safe and effective alternative to open surgery for ileal ureter substitution. Extracorporeal management of the ileal segment would appear advantageous because it reduces operative time and morbidity.
authors.affiliation: Section of Endourology and Laparoscopic Urology, Clínica Santa María, Santiago, Chile. octaviocastillo@vtr.net
authors.forename: Octavio A
authors.initials: OA
authors.lastname: Castillo
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanchez-Salas
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Vitagliano
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Diaz
authors.forename: Alejandro
authors.initials: A
authors.lastname: Foneron
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014513:Ureter / Q000601:surgery*; D014515:Ureteral Diseases / Q000209:etiology / Q000601:surgery*; D053039:Ureterolithiasis / Q000150:complications