Laparoscopic retroperitoneal approach for retrocaval ureter in children
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Retrocaval ureter (RCU) is a rare congenital anomaly and published data on pediatric laparoscopic management are poor. The aim of this study was to report our experience of retroperitoneal laparoscopic approach for management of RCU in children.
A retrospective review of data from patients treated for RCU between 2002 and 2018 in our institution was performed. All patients were positioned in a flank position and underwent a three-port (5-mm optical trocar and two 3-mm trocars) laparoscopic retroperitoneal ureteroureterostomy. Anastomosis was made by 6/0 absorbable sutures. A JJ stent was always inserted.
Five patients with a median age of 94 months (5–152) were operated on and followed up for a median time of 103 months (46–201). Median operating time was 200 min (160–270). No conversion and no transfusion occurred. Median hospital stay was 2 days (1–4). Ureteral stent was removed after 52 days (47–82). Complications included pyelonephretis (N = 1). In all cases, hydronephrosis decreased postoperatively.
Retroperitoneal laparoscopic approach for RCU is safe and effective in children. Our video demonstrates different patients with specific surgical details to show how to manage these children. The global vision of the upper tract by laparoscopy leads to optimal management of these children even if the anomaly was not detected preoperatively.
KeywordsRetrocaval ureter Hydronephrosis Multimodal imaging Retroperitoneal space Laparoscopy Child
Differential renal function
Inferior vena cava
Length of stay
- Mg dL−1
Milligram per deciliter
Magnetic resonance imaging
Pelvi-ureteric junction (obstruction)
Urinary tract infection
MP: project development, data management, data analysis, manuscript writing. GR: project development, data collection. AT: data management, manuscript writing. COM: data collection, data analysis. TB: manuscript editing. HA: manuscript editing. AP-J: project development, data management, manuscript editing. AE-G: project development, data analysis, manuscript writing and editing.
Compliance with ethical standards
This study had received Robert-Debré University Hospital review board approval. No help or financial support from any industrial firm has been declared. We have received a signed release form from the patient’s families authorizing this publication.
Conflict of interest
All authors declare the following: Payment/services info: all authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous 3 years with any organizations that might have an interest in the submitted work. Other relationships: all authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
Supplementary material 1 (M4V 139146 kb)
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