title: Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructed megaureter: a novel technique.
abstract: BACKGROUND
  To describe a novel technique using extracorporeal tailoring and an inverted ureteral nipple to perform laparoscopic transperitoneal ureteral reimplantation for adult obstructed megaureter and our initial experience with 10 patients.
  
  
  METHODS
  Ten patients (mean age 39.2 years [range, 21-62]) with adult obstructed megaureter underwent transperitoneal laparoscopic ureteral reimplantation by a 3- or 4-port technique. In each case, the affected ureter was freed and delivered out of the peritoneal cavity through the ipsilateral 12-mm port. The lower end of the ureter was tailored by approximately 6 cm, and the tip was folded back onto itself and secured with absorbable sutures to form a nipple. A double-J stent was placed, the entire assembly was carefully replaced into the abdomen, and the ureter was reimplanted into the posterolateral wall of the bladder.
  
  
  CONCLUSIONS
  Surgery was successful in all the 10 patients without the need for open conversion. At a mean follow-up of 17 months, all patients were asymptomatic, and hydronephrosis was relieved in 9 cases. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is an easy, safe, and effective procedure for adult obstructed megaureter.
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: He
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.forename: Xuesong
authors.initials: X
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Yao
authors.forename: Zhisong
authors.initials: Z
authors.lastname: He
authors.forename: Liqun
authors.initials: L
authors.lastname: Zhou
mesh_terms: D000328:Adult; D003559:Cystostomy / Q000295:instrumentation / Q000379:methods*; D004322:Drainage; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012092:Replantation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D055815:Young Adult