Percutaneous ureteral catheterization in laparoscopic surgery: value of nephroscopy needle trocar.
OBJECTIVE
To report our experience with use of the nephroscopy needle trocar for percutaneous catheterization. In multiple urologic procedures, surgeons use ureteral catheters to decrease morbidity, increase the success rate, and allow for postoperative radiographic follow-up. The advent of laparoscopic surgery has logically required catheterization to be adapted to our laparoscopic procedures.


METHODS
The expansion of our daily practice to include multiple laparoscopic procedures showed us the difficulties inherent to ureteral catheterization in laparoscopic surgery. During our experience of >1000 laparoscopic procedures, we have used more or less complex catheterization techniques. After developing the use of the nephroscopy needle trocar for laparoscopic urinary diversion and finding that such use simplified the procedure, this technique was extended to all other laparoscopic procedures in which catheterization is required.


RESULTS
We analyzed the use of the nephroscopy needle trocar in 15 ureteropyeloplasty, 21 ileal conduit, and 4 laparoscopic ureteral reimplantation procedures. The mean operating time required for anterograde catheterization in ureteropelvic junction stenosis was 3 minutes, 35 seconds, and the mean operating time for retrograde catheterization was 2 minutes, 20 seconds. Anterograde catheterization was impossible in 1 case. No cases of a false ureteral tract occurred.


CONCLUSIONS
The results of our analysis have shown that the use of the nephroscopy needle trocar for percutaneous catheterization in laparoscopic surgery markedly simplifies the procedure, with the resultant savings in operating time.
Alonso
Sergio
S
Department of Urology, La Paz Hospital, Madrid, Spain. garavelos@terra.es
Alvarez
Mario
M
Cabrera
Pedro M
PM
Rodriguez
Fermin
F
Cansino
Ramon
R
Tabernero
Angel
A
Cisneros
Jesus
J
de la Peña
J Javier
JJ
D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009339:Needles; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery; D014546:Urinary Catheterization / Q000295:instrumentation* / Q000379:methods*; D014547:Urinary Diversion / Q000295:instrumentation / Q000379:methods*