ABSTRACT
The authors developed an operative cystoscope with joystick control mechanism of ureter catheters and other flexible tools. This construction allowed control of flexible tools inserted into the bladder and the ureter in various directions, thus providing a necessary observation of the operative field at endoscopic operations on the bladder and ureter. This was one of the factors, which determined the operation success.
Subject(s)
Cystoscopes/trends , Cystoscopy/instrumentation , Intraoperative Care/instrumentation , Robotics/methods , Urinary Bladder Diseases/surgery , Cystoscopy/methods , Equipment Design , Fiber Optic Technology/methods , Humans , Treatment Outcome , Urinary Bladder/surgerySubject(s)
Cystocele/surgery , Urethral Diseases/surgery , Vesicovaginal Fistula/surgery , Aged , Cystocele/diagnosis , Cystocele/etiology , Female , Humans , Recurrence , Time Factors , Treatment Outcome , Urethral Diseases/complications , Urethral Diseases/diagnosis , Vesicovaginal Fistula/complications , Vesicovaginal Fistula/diagnosisABSTRACT
The article presents the results of lumbar ureteral defect replacement with the intact contralateral ureter left after removal of the kidney. The new surgical technique is used in long ureteral stricture. This defect is corrected by transplantation of the intact ureter of the contralateral removed kidney. The operation consists of the following stages: median laparotomy; medial shift of the colon; lumbar mobilization of the intact ureter of the contralateral or afunctional kidney with preservation of the ureteral vessels; creation of the retroperitoneal tunnel ahead of the major vessels; drawing of the ureter through the tunnel to the opposite direction; isolation of the lower pole of the kidney, pelvis and proximal ureter; creation of the ureteropyelo- or ureteroureteroanastomosis end-to-end on the stent; bilateral drain of the retroperitoneal space. This procedure was used in two men with a long lumbar stricture of the ureter of the single kidney after several operations on the upper urinary tract. Postoperative complications were absent. The wound healed with primary intention. The intubator was removed on day 14. After removal of the stent on day 16 the patients were discharged from the hospital for outpatient treatment. Urodynamics of the upper urinary tract recovered in both the patients. Thus, in some cases normal ureter of afunctional or removed kidney can be used for plastic repair of a long defect of the contralateral ureter. This surgical technique provides good functional results.
