title: Laparoscopic dissection of the intramural ureter to repair a complete transection of the distal ureter: Initial experience with a new minimally invasive technique that preserves the anatomy of the urinary tract.
abstract: We report 2 patients with ureteral injury after a simple total laparoscopic hysterectomy for uterine myoma with a complete resection of the distal ureter. One patient had unilateral injury and the other 2 patients had bilateral injury. The surgical laparoscopic repair procedure was carried out 3 to 5 days after the injury. Surgery involved intramural dissection of the distal ureteral stump to expose at least 1 cm of the ureter, percutaneous ureteral stent placement, elimination of tension between the proximal ureter and the dissected distal stump, end-to-end anastomosis, and reinsertion of the distal ureter into the bladder muscle layer, which was previously dissected for the anastomosis.
authors.affiliation: Urology Department, Hospital de Jerez, Cadiz, Spain;
authors.forename: Alvaro
authors.initials: A
authors.lastname: Juarez-Soto
authors.affiliation: Urology Department, Hospital de Jerez, Cadiz, Spain;
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Arroyo-Maestre
authors.affiliation: Urology Department, Hospital de Jerez, Cadiz, Spain;
authors.forename: Manuel
authors.initials: M
authors.lastname: Soto-Delgado
authors.affiliation: Urology Department, Hospital de Jerez, Cadiz, Spain;
authors.forename: Pastora
authors.initials: P
authors.lastname: Beardo-Villar
authors.affiliation: Surgery Department, Faculty of Medicine, Granada University, Granada, Spain;
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Arrabal-Polo
authors.affiliation: Center for Minimally Invasive Surgery Jesus Usón, Caceres, Spain.
authors.forename: Francisco Miguel
authors.initials: FM
authors.lastname: Sánchez-Margallo