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A simple and safe technique for trocar positioning in vesicoscopic ureteric reimplantation

Publication Type : Journal Article

Publisher : Pediatric Surgery International

Source : Pediatric Surgery International, Volume 27, Number 11, p.1223-1226 (2011)

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Keywords : abdominal wall, article, bladder wall, child, clinical article, Clinical trial, cystoscopy, dilator, endoscopic surgery, Equipment Design, female, follow up, Follow-Up Studies, human, Humans, incision, infant, male, megaureter, operation duration, patient safety, pediatric surgery, Preschool, preschool child, priority journal, Prospective Studies, reimplantation, Replantation, surgical equipment, Suture Techniques, Sutures, suturing method, treatment outcome, trocar, Ureter, ureter reimplantation, Urinary Bladder, Urination, Urologic Surgical Procedures, Vesico-Ureteral Reflux, vesicosopic ureteric reimplantation

Campus : Kochi

School : School of Medicine

Department : Paediatric Surgery

Year : 2011

Abstract : Purpose: Anchoring of the urinary bladder to the anterior abdominal wall is essential to prevent perivesical gas leak and dislodgement of trocar. Existing techniques have the risk of going through the peritoneal cavity and injuring the bowel. Our aim was to find a safe technique to anchor the bladder wall to the abdominal wall. Materials and methods: Nineteen cases were studied prospectively. A curved urethral dilator was introduced and made to point on the anterior abdominal wall. Abdominal wall was incised over the tip of the dilator till the bladder was seen which was then sutured to the anterior abdominal wall. The bladder was then incised and the trocars were railroaded on the dilator into the bladder. Cohen's reimplantation was then done. Results: Out of the 19 cases, conversion to open was done in two early cases. In one case, the trocar got pulled out, but was easily reintroduced. Mean operating time was 210 min. Mean follow up was 20.9 months. There was a resolution of reflux in 13, reduction in the grade of reflux in 1 and no failures. In five cases, post op MCU is awaited. Conclusion: This technique of fixing the bladder to the anterior abdominal wall is safe and easy to perform. It is recommended while doing vesicoscopic reimplantation. © 2011 Springer-Verlag.

Cite this Research Publication : M. K. Abraham, Viswanath, N., Bindu, S., Kedari, P., Ramakrishnan, P., Naaz, A., and Mohan, S., “A simple and safe technique for trocar positioning in vesicoscopic ureteric reimplantation”, Pediatric Surgery International, vol. 27, pp. 1223-1226, 2011.

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