title: Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies.
abstract: OBJECTIVE
  Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU) for duplex anomalies.
  
  
  METHODS
  The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results.
  
  
  RESULTS
  Over 3 years period, LIUU was performed in eight children (age 6-60 months). Five children had complete ipsilateral duplication with ectopic upper moiety ureter, one child each had ipsilateral incomplete duplication and bilateral duplex systems (with ipsilateral ectopic upper moiety ureter). One child had ipsilateral complete duplex with Grade V vesicoureteric reflux into the lower moiety ureter. Four children had antenatal diagnosis of hydronephrosis; three children had a urinary infection and two children presented with urinary incontinence. The surgical procedure consisted of cystoscopy, retrograde studies and cannulation of the recipient ureter. Then, LIUU was performed using three ports. The ectopic (donor) ureter was divided at the pelvic brim; the recipient ureter was opened and end-to-side LIUU was performed with 5/0 vicryl stitches over a double J (DJ) stent placed in the recipient ureter. Bladder catheter was removed after 2 days, and DJ stent was removed after 4 weeks. At a mean follow-up of 19 months (3-36), all children are asymptomatic and continent, with a significant reduction in hydroureteronephrosis on ultrasound. The cosmetic results were excellent.
  
  
  CONCLUSIONS
  LIUU is a safe and effective technique in the management of duplication anomalies in children. It could be performed with minimal blood loss, minimal postoperative pain, excellent cosmesis and good success.
authors.affiliation: Department of Pediatric Surgery, Pediatric Urology and MAS, Rainbow Children's Hospitals, Hyderabad, Telangana, India.
authors.forename: Vvs
authors.initials: V
authors.lastname: Chandrasekharam
authors.affiliation: Department of Pediatric Surgery, Pediatric Urology and MAS, Rainbow Children's Hospitals, Hyderabad, Telangana, India.
authors.forename: Harish
authors.initials: H
authors.lastname: Jayaram
keywords: Child; duplex; laparoscopy; ureteroureterostomy