HomeArchiveVolume 6Volume 6, issue 2Ureteral injury during laparoscopic rectal resection and concurrent laparoscopic repair by uretero-ureterostomy

Fatih Sumer1, Gökalp Okut1*, Ramazan Kutlu2, Mehmet Ali Yağcı3, Cuneyt Kayaalp4

1INONU UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF GASTROENTEROLOGY SURGERY, MALATYA, TURKEY
2INONU UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF RADIOLOGY, MALATYA, TURKEY
3ÖZEL ANKA HOSPITAL, DEPARTMENT OF SURGERY, GAZIANTEP, TURKEY
4YEDITEPE UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF SURGERY, ISTANBUL, TURKEY

Abstract

Iatrogenic ureteral injury is an uncommon but severe complication of laparoscopic colorectal surgery. If it is detected intraoperatively, conversion to open surgery is usually inevitable. Here, we described a complete ureteral transection during laparoscopic low anterior resection, which was simultaneously repaired by laparoscopic uretero-ureterostomy. The most important points during the anastomosis of two tiny tubular tissues are dissecting the tubular organs without trauma, obtaining meticulous hemostasis without causing any necrosis, and achieving accurate approximation of tissues with the sutures. To the best of our knowledge, this is the first report that focused on laparoscopic repair of ureteral injury during laparoscopic colorectal surgery. As there are still few data on laparoscopic repair of ureteral lesions, no firm conclusions can be drawn. But, in appropriate cases, if intracorporeal suture expertise is available, laparoscopic repair can be done during colorectal surgery.