Original article antibiotics and surgery for vesicoureteric reflux. Extravesical ureteral reimplantation following lichgregoir. The aim is to compare the outcome of open versus laparoscopic lichgregoir technique in patients with vesicoureteral reflux. Ureteric reimplantation the traditional modes of investigation and management of primary vesicoureteric reflux vur are undergoing dramatic revision. In our study, routine prophylactic stenting combined with the lichgregoir unc technique has decreased the incidence of postoperative fistulae. We report a retrospective multicenter comparative study between open and laparoscopic extravesical ureteral reimplantation evur following lichgregoir lg technique for the correction of vesico ureteral reflux vur. We report a retrospective multicenter comparative study between open and laparoscopic extravesical ureteral reimplantation. Mar 03, 2017 the roboticassisted ureteral reimplantation the development of the roboticassisted laparoscopic ureteral reimplantation has tracked a path searching for the optimal method of providing outcomes on par with the gold standard of open intravesical ureteral reimplantation combined with fewer complications and decreased discomfort for the patient. Laparoscopic lich gregoir extravesical ureteric reimplantation for. Jun 21, 2017 vesicoureteral reflux vur represents one of the most significant risk factors for acute pyelonephritis in children. Animal tissue has been used to simulate a surgical procedure. The aim of this study was to describe the evolution and evaluate the results and benefits of this technique. In 1903, sampson conducted several experiments in dogs, after which he also described the case of a woman in whom he reimplanted the left ureter via an extraperitoneal approach on 20 july 1903 and the right on 8 september 1903, using local anaesthesia. Extravesical ureteral reimplantation lichgregoir and our.
Interestingly, no perioperative complication was reported in these procedures to date. All of these patients had graft hydronephrosis detected on urgent uss, not routine psrgu. Lich gregoir technique was performed with a 7french, 15cm long, double j ureteric stent in situ. Original article antibiotics and surgery for vesicoureteric. In a descriptiveanalytical study, 32 children with 47 reflux unit underwent lich gregoir antireflux procedure in imam reza and amiralmomenin hospitals, tabriz between march 2008 and august 2011. From 1 january 2009 to 31 july 2012, seven children were treated with laparoscopyassisted cutaneous ureterostomy followed by. The aim of this study is to assess short and mediumterm outcomes of this approach. Reconstruction was done by closing the bladder defect and ureteric reimplantation using lich gregoir technique. Gregoir procedure 2,5, in which the submucosal tunnel is created superior to the ureteric orifice.
Lichgregoir technique was performed with a 7french, 15cm long, double j ureteric stent in situ. Eight cases of primary obstructive megaureter in the age group of 1422 years underwent laparoscopic extravesical ureteric reimplantation between august 2011 and july 2015 using our novel technique. Laparoscopic ureteric reimplantation using the lichgregoir technique is an option for vur. This is an educational video for surgical trainees. Paquin first proposed that a short intramural ureteric tunnel. Laparoscopic simultaneous bilateral ureteric tailoring. Hendren 11 used the lichgregoir procedure in 43 ureters and had success in only 18.
Reconstruction was done by closing the bladder defect and ureteric reimplantation using lichgregoir technique. Ureteroneocystostomy versus ureteric stenting for the. Laparoscopic extravesical ureteral reimplantation following. Lichgregoir reimplantation causes less discomfort than politano. Current study evaluates effectiveness and success rate of the lichgregoir procedure in treatment of the vesicoureteral reflux. Request pdf on jul 1, 2008, hubertus riedmiller and others published. Ureteroneocystostomy unc refers to reimplantation of the ureter into the. Laparoscopic extravesical lich gregoir procedure in. Indications and effectiveness of the open surgery in.
The patient was haemodynamically stable but remained. Transvesicoscopic cohen ureteric reimplantation for vesico. Read ureteral complications in renal transplantation. Robotic management of pheochromocytoma of the vesicoureteric. The lich gregoir extravesical ureteral reimplantation, as well as modifications thereof, has become the standard technique for management of the ureter during renal transplantation.
Extravesical ureteral reimplantation following lich. Vesicoureteral reflux vur, also known as vesicoureteric reflux, is a condition in which urine flows retrograde, or backward, from the bladder into the ureterskidneys. These results should encourage the use of this technique when. A needle test to aspirate prefilled gentamicin solution from the bladder was done and extravesical ureteroneocystostomy with lichgregoir technique was performed with a 7french, 15cm long, double j ureteric stent in situ. The modified lichgregoir technique of extravesical ureteral reimplantation is successful, simple to perform, reproducible and associated with low morbidity. Jun 22, 2011 vesicoureteral reflux vur is the most common uropathy affecting children. The roboticassisted ureteral reimplantation abdominal key.
Lichgregoir extravesical ureteric tunnelling hubertus riedmiller and elmar w. Vesicoureteral reflux vur is the most common uropathy affecting children. The modified lichgregoir technique of extravesical ureteral reimplantation is successful, simple to perform, reproducible and associated with low. The politanoleadbetter reimplantation is technically somewhat more complex and dif. Fullthickness single layer anastomosis and lichgregoir abstract urinary complications such as urine leak, stricture, ureteric obstruction and vesicoureteral reflux are the most common technical adverse events following. Extravesical ureteral reimplantation lich gregoir and our experience at king hussein medical center zahran budair, md, khalaf aljader, md, mohannad alnaser, md abstract objective. The aim is to compare the outcome of open versus laparoscopic lich gregoir technique in patients with vesicoureteral reflux. We report our initial experience in the treatment of refluxing dcs by laparoscopic extravesical transperitoneal approach leta following lichgregoir technique. It also requires a minimal hospital stay, a fact that cannot be overlooked in this time of budget restriction.
First references to vur by western medicine uvj as a mediator of unidirectional flow of urine from the kidneys to the bladder. Current study evaluates effectiveness and success rate of the lich gregoir procedure in treatment of the vesicoureteral reflux. Although ureteric reimplantation is an invasive method of treatment, the rate of complications has not been studied. Peritoneal implantation of ureter in cadaveric renal. Gerharz department of urology and paediatric urology, bavarian julius maximilians university medical school, wurzburg, germany illustrations by stephan spitzer. Intraoperative abdominal x ray was done to confirm three months later in the patients who had successful endoscopic ureteric stenting. Extravesical modified gregoir lich versus intravesical. Peritoneal implantation of ureter in cadaveric renal transplant. This study aims to demonstrate a novel laparoscopic technique of tapering megaureter without disrupting the blood supply and disconnecting the ureter. A single center experience krishnamoorthy sriram, ramesh babu department of urology, sri ramachandra medical college, porur, chennai, tamil nadu, india. Though an initial attempt to save the ureter was made during robotic surgery, the realization of ureter being involved by tumor led us to add distal ureterectomy to partial cystectomy. Novel technique of laparoscopic extravesical ureteric. Currently, the most popular procedures are the lich.
Long term outcomes of laparoscopic and open modified lich. Current status of gilvernet trigonoplasty technique. We report a retrospective multicenter comparative study between open and laparoscopic extravesical ureteral reimplantation evur following lichgregoir lg technique for the correction of vesicoureteral reflux vur. Currently, success rates between 95% and 98% for open ureteral reimplantation are. A comparison of the lich gregoir versus the taguchi technique, transplantation proceedings on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Do not watch if you are easily offended by surgical procedures.
A total of 385 vesicoureteral units were reimplanted, including 41 duplex systems. Ureteral reimplantation without opening the bladder lich gregoir 1964. We report a retrospective multicenter comparative study between open and laparoscopic extravesical ureteral reimplantation evur following lich gregoir lg technique for the correction of vesicoureteral reflux vur. In a descriptiveanalytical study, 32 children with 47 reflux unit underwent lichgregoir antireflux procedure in imam reza and amiralmomenin hospitals, tabriz between march 2008 and august 2011. Coimbra 12th spcmin congress october, 18, 2019 friday. Indications and effectiveness of the open surgery in vesicoureteral reflux. Ureteric reimplantation has been associated with a very high success rate of 98. Oct 29, 2015 laparoscopic extravesical lich gregoir procedure in pediatric patients with vesical ureteral reflux.
Leadbetter reimplantation is technically somewhat more complex and difficult than, e. Various techniques of ureteral reimplantation have been described for the correction of vesicoureteral reflux. From 1 january 2009 to 31 july 2012, seven children were treated with laparoscopyassisted cutaneous ureterostomy followed by ureteric reimplantation. Of those patients, 35 had their stents removed urgently median interquartile range, iqr number of days after transplant 21 1431. The lichgregoir method of extravesical ureteral reimplantation is successful, simple to perform, reproducible and associated with low morbidity. Even with such advances, laparoscopic extravesical ureteral reimplantation for iatrogenic distal ureteral strictures in adults remains rarely reported and consists primarily of case reports table 1. The chicken model for laparoscopic left modified lich gregoir type of ureteric reimplantation is a useful, effective, cognitive training tool. Jan, 2016 various approaches to ureteral reimplantation in the adult can be used, such as a modified politanoleadbetter type of repair and an extravesical lich gregoir. Persistence and appearance of vesicoureteral reflux. Ureteral reimplantation without opening the bladder lichgregoir 1964. Introduction vur is the most common urological anomaly.
Compared to children without vur, those with vur have a higher rate of pyelonephritis and renal scarring following urinary tract infection uti. The modified lichgregoir technique of extravesical ureteral reimplantation is. Vesicoureteral reflux vur represents one of the most significant risk factors for acute pyelonephritis in children. The modifi cation to the lichgregoir technique we used consists of ending the.
The modified lich gregoir technique of extravesical ureteral reimplantation is successful, simple to perform, reproducible and associated with low morbidity. Frontiers extravesical ureteral reimplantation following. The earliest attempt at ureteric reimplantation was reportedly by nussbaum in 1876. These results should encourage the use of this technique when indicated to correct vesicoureteral reflux in children. Called the prostate cancer of paediatric urology, vur has been overinvestigated and perhaps in some cases overtreated. This model has a face, content, and construct validity to be used as a teaching and learning tool in laparoscopic urology. Four of these patients subsequently underwent ureteric reimplantation for ureteric stenosis 435. Surgical management of vesicoureteral reflux in children.
Extravesical modified gregoir lich versus intravesical cohens ureteric reimplantation for vesicoureteral reflux in children. In our study bladder spasms occurred significantly less frequently after the lichgregoir reimplantation. Since in extravesical lichgregoir technique a catheter does not need to be left in bladder, it is associated with reduced bladder spasm and discomfort, and hematuria. Face, content, and construct validity of a novel chicken. Laparoscopy may have a place in the treatment of vur. Request pdf laparoscopic extravesical ureteral reimplantation following lichgregoire technique. For future open reimplantation, ureterostomy can be created by minimal invasive technique at the ends of the suprapubic creaseline.
Management of ureteral complications in renal transplantation. Jun 01, 2007 read ureteral complications in renal transplantation. Ureteral reimplant performed for vur utilized the nonrefl uxing lich gregoire. The total operating time was 2 hours and 20 minutes. In our study bladder spasms occurred significantly less frequently after the lich gregoir reimplantation. Recently, a study has described gilvernet trigonoplasty without. Others emphasized that suprapubic catheterization causes less pain and discomfort than urethral catheterization due to reduced bladder neck irritation. Laparoscopyassisted cutaneous ureterostomy at suprapubic. Laparoscopic vesicoureteral reimplantation with lichgregoir.
No urine was noted at cutend of the graft ureter at the time of implantation. A comparison between two kidney transplant ureteroneocystostomy techniques. The roboticassisted ureteral reimplantation the development of the roboticassisted laparoscopic ureteral reimplantation has tracked a path searching for the optimal method of providing outcomes on par with the gold standard of open intravesical ureteral reimplantation combined with fewer complications and decreased discomfort for the patient. Lichgregoir technique and routine use of double j catheter.
Urine normally travels in one direction forward, or anterograde from the kidneys to the bladder via the ureters, with a 1way valve at the vesicoureteral ureteralbladder junction preventing backflow. Introduction vur has been the subject of many studies and reports, which include presentations of many operative procedures for surgical management. A needle test to aspirate prefilled gentamicin solution from the bladder was done and extravesical ureteroneocystostomy with lich gregoir technique was performed with a 7french, 15cm long, double j ureteric stent in situ. Surgical atlaspolitanoleadbetter ureteric reimplantation. Lichgregoir reimplantation causes less discomfort than. Between december 2008 and december 2014, 32 open cases and 29 laparoscopic cases were performed as per the data retrieved from surgical databases. Renal transplantation is the best choice in the treatment of endstage renal disease. In our study, routine prophylactic stenting combined with the lich gregoir unc technique has decreased the incidence of postoperative fistulae. Lichgregoir procedure in treatment of the vesicoureteral reflux. Key words ureterovesical reimplantationlich gregoirureteral stenosiskidney transplantcomplications.
Introduction vesicoureteral reflux vur represents the retrograde flow of urine from the bladder to the upper urinary tract galen and da vinci. The surgical correction of vesicoureteral reflux vur is the most frequent operation on the upper urinary tract in children. The lichgregoir extravesical ureteral reimplantation, as well as. The duration of hospitalization after surgery ranged from 1 to 3 days. Laparoscopic extravesical transperitoneal approach following. Conventional treatment of obstructive megaureter entails disconnection proximal to the pathological segment, tailoring of the dismembered ureter, and ureteric reimplantation. Politanoleadbetter, lichgregoir and cohen have gained the greatest popularity over the past four decades 25. Laparoscopic extravesical lich gregoir procedure in pediatric patients with vesical ureteral reflux. Dewan urology unit, royal childrens hospital, parkville, victoria, australia. The aim of this study was to describe the evolution and.
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