FIELD: medicine; pediatric urology; andrology; pediatric surgery.
SUBSTANCE: ureter of the upper segment of the kidney is cut off, and the ureter of the lower segment is dissected longitudinally. The posterior lip of the ureteroureteroanastomosis is formed. By puncture through the anterior abdominal wall, 1–2 cm lateral to the central trocar, a Veress needle is inserted into the abdominal cavity, passed through the upper segment of the kidney, collecting system, parenchyma, kidney capsule and lumbar muscles towards the paravertebral line, the Veress needle is brought out through puncture in the lumbar region, remove the obturator from the Veress needle. The distal end of the pyeloplastic catheter is inserted through the section of the Veress needle and, using anatomical tweezers, the catheter is advanced through the needle and removed from the proximal end of the Veress needle, the Veress needle is removed, then the pyeloplastic catheter is advanced into the abdominal cavity using traction for the proximal end of the pyeloplastic catheter, using a laparoscopic clamp the distal end of the pyeloplastic catheter is inserted through the anastomosis into the lower segment of the kidney, and the anterior lip of the anastomosis is formed. The proximal end of the catheter is fixed to the skin of the lumbar region with sutures and adhesive bandage, and is connected to a urinal.
EFFECT: method makes it possible to increase the efficiency of drainage of ureteroureteroanastomosis during laparoscopic proximal ureteroureterostomy, eliminates preliminary cystoscopy for the purpose of stenting the “recipient” ureter, and, accordingly, such complications as stent migration, the need to remove the stent under anesthesia, as well as the occurrence of symptoms of dysuria, reduces the operation time, besides, the claimed drainage method ensures reliable and controlled urine drainage in the postoperative period and rapid healing of the anastomosis.
1 cl, 14 dwg, 1 ex
