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11–14 APRIL, 2018, HELSINKI, FINLAND
MATERIAL AND METHODS
The patient was a-13-year-old girl. She was first presented with hematuria. Ultrasonography de-
tected 5 cm simple renal cyst. The cyst was rapidly increased in size up to 8 cm in a year with low
back pain. DMSA showed no deterioration of differential renal function. Laparoscopic resection of
renal cyst was planned.
RESULTS
The patient was placed lateral decubitus position, 5-mm camera port was inserted at the umbilicus
and other two 5-mm trocars were introduced. After mobilization of the kidney, SAND balloon cath-
eter was directly injected into an appropriate point of the distended cyst wall percutaneously under
laparoscopic guide. Distal balloon was gently inflated first and proximal balloon was expanded
subsequently. The cyst wall was sealed by two balloons from inside and outside then fluid was
extracted without leakage. SAND balloon catheter minimized the spillage of cystic contents. It was
also used as an extra working instrument. The collapsed cyst was well controlled and the cyst was
excused as much as possible with electric device and withdrawn via umbilical port. The patient was
discharged 4 days after the surgery and no recurrence has been noted.
CONCLUSIONS
SAND balloon catheter is safe and efficient tool for laparoscopic surgery which could be used for
other selected cystic lesions.
VD-14 (VS without presentation)
LAPAROSCOPIC URETEROURETEROSTOMY FOR
RETROCAVAL URETER
Sonia PÉREZ-BERTÓLEZ, Oriol MARTÍN, Jenny ARBOLEDA, Andrea SORIA and
Luis GARCÍA-APARICIO
Hospital Sant Joan de Déu, Pediatric Urology, Pediatric Surgery, Barcelona, SPAIN
PURPOSE
A retrocaval ureter is a rare congenital anomaly that results from persistence of the right posterior
cardinal vein in the lumbar portion, crossing anterior to the middle segment of the ureter. The aim of
this video is to show the steps of a laparoscopic repair of retrocaval ureter.
MATERIAL AND METHODS
Case report.
RESULTS
A 8-year-old boy presented with progressive hydronephrosis of a solitary right kidney, with dilatation
of the proximal ureter. The patient was operated on with a transperitoneal four ports approach under
general anesthesia. A 10Fr Foley catheter was inserted. Patient was placed in 30º left lateral posi-
tion. Open trocar placement was done at the umbilucus (5 mm), the rest 3 mm ports were placed at
epigastrium, right hypocondrium and right iliac phossa. The ascending colon was reflected medially
to expose the retroperitoneum. The ureter was identified coursing posterior to the inferior vena
cava. Then, the proximal right ureter was dissected and mobilized. The ureter was transected and
transposed anterior to the inferior vena cava, excising the retrocaval portion. The distal ureter was
spatulated. A 4.8Fr double-J stent was inserted in an antegrade manner. A ureteroureterostomy
was done with 5.0 vicryl by intracorporeal suturing. A closed suction drain was placed. Duration of
the surgery was 100 minutes. The drain was removed after 72 hours and patient was discharged.
Stent removal was done on the 2
nd
postoperative month. Postoperative follow-up with ultrasound
showed significant reduction of hydronephrosis.