Laparoscopic extravesical ureteral reimplantation of primary obstructive megaureter in children

Introduction. Laparoscopic extravesical ureteral reimplantation is gradually implemented in some pediatric urological centers in the USA, Israel and Europe, but there is currently no consensus about proper surgical technique to achieve the best possible results. The purpose of the study. To describe modification of Lich—Gregoir techniques which can simplify this complex laparoscopic procedure. Materials and methods. From January 2018 to December 2019, 9 laparoscopic ureteral reimplantations were performed in the neo-natal surgical center of the Ivano-Matreninsky Children’s Hospital of Irkutsk. There was a new adjustment in Lich—Gregoir technique, which included in using of preoperative cystoscopy to carry out submucosal hydrodissection for recreation of submucosal tunnel. Results. Laparoscopic extravesical ureteral reimplantation was successfully performed in all 9 patients without conversion to open surgery or laparoscopically-assisted procedure. One of the success criteria was the absence of technical obstacles to perform ure-terovesicostomy. During the operational process, no serious intraoperative complications were noted. All patients were asymp-tomatic during 12 months of follow-up period. Conclusion. The modified Lich-Gregoir technique of laparoscopic surgery treatment is proposed as the new standard for mini-in-vasive treatment of primary obstructive megaureter.