Laparoscopic Ureteroureterostomy for Retrocaval Ureter

ObjectivesTo debate the different laparoscopic approaches for the surgical management of patients with circumcaval ureter.MethodsUpdated literature review and discussion of personal experiences concerning the laparoscopic treatment of the circumcaval ureter.ResultsLaparoscopic approaches promote less intraoperative bleeding, a shorter postoperative hospital stay, reduced postoperative pain, earlier return to daily activities and a significant superior aesthetics effect, while preserving therapeutic efficacy in performing reanastomosis of a circumcaval ureter. The main limiting factor for both a transabdominal and a retroperitoneal laparoscopic repair is the intracorporeal anastomosis of the ureter, which significantly increased the surgical time. Interestingly, a laparoscopic pyelopyelostomy for retrocaval ureter without resection of the retrocaval segment has been debated.ConclusionsComparisons among historical reports regarding open surgery and laparoscopic transposition and reanastomosis of a circumcaval ureter have clearly shown the advantages of minimally invasive approaches.