ESPU Congress 2018 - Abstract Book

198 29 th CONGRESS OF THE ESPU VD-4 (VS without presentation) LAPAROSCOPIC EXTRAVESICAL URETERAL REIMPLANTATION TECHNIQUE AFTER FAILED‑ENDOSCOPIC SURGERY FOR VESICOURETERAL REFLUX Jenny ARBOLEDA, Oriol MARTÍN-SOLÉ, Sonia PÉREZ-BERTÓLEZ and Luis GARCÍA-APARICIO Hospital Sant Joan de Déu, Pediatric Urology, Pediatric Surgery, Barcelona, SPAIN PURPOSE Ureteral reimplantation should be considered for treating persistent vesicoureteral reflux (VUR) after endoscopic treatment. Laparoscopic extravesical ureteral reimplantation is gaining popularity on recent years. We present a video of laparoscopic extravesical ureteral reimplantation after two failed endoscopic surgeries for VUR. MATERIAL AND METHODS A 2-year-old boy with persistent left grade IV VUR after two failed endoscopic treatments, with 22 % differential renal function on DMSA-scan was operated. The patient was placed in Trendelenburg position and a Foley catheter was inserted. Open trocar placement was done at the umbilicus (5 mm). The other two 3 mm trocars were placed along the lateral border of the rectus. The perito- neum was opened over the posterior bladder wall and the distal ureter was dissected, taking care not to damage the vas deferens. A transabdominal hitch suture through the bladder was used to expose its posterior wall. The position bladder through was marked with hook electrocautery and the muscle fibres were divided with sharp scissors until the mucosa bulged. The bladder was filled with physiological saline to expose and identify the mucosa, which facilited the detrusorraphy with 5–0 vicryl. RESULTS The Foley catheter was removed after 24 hours and the patient was discharged. The postoperative voiding cystourethrogram showed resolution of VUR CONCLUSIONS Laparoscopic extravesical ureteric reimplantation represents a feasible, safe and low morbidity technique for retreatment of VUR in children. VD-5 (VS without presentation) ROBOT-ASSISTED LAPAROSCOPIC DISMEMBERED URETERAL REIMPLANT WITH TAPERING Diana K. BOWEN  1 , Aseem R. SHUKLA  2 and Arun K. SRINIVASAN  1 1) The Children's Hospital of Philadelphia, Division of Pediatric Urology, Department of Pediatric Surgery, Philadelphia, USA - 2) The Children's Hospital of Philadelphia, Division of Pediatric Urology, Department of Surgery, Philadelphia, USA PURPOSE Primary obstructive megaureter represents a challenging case robotically as the ureter is not only dilated but often tortuous and redundant. We demonstrate our technique for a robotic dismembered tapered ureteral reimplant, emphasizing the ureteral anastomosis and tapering components.