Category: Laparoscopy: Upper Tract - Malignant

VS11-11 - Pure Laparoscopic Nephroureterectomy and Bladder Cuff Resection for a Lower Ureteral Tumor

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

We aim to demonstrate our approach for pure laparoscopic nephroureterectomy and bladder cuff resection.


Methods :

This 70-year-old man with no known systemic disease presented with right acute pyelonephritis and acute kidney injury, temporary pigtail drainage was done. Followup CT urography showed a right distal ureteral tumor, and the morphology showed Ta, high grade urothelial carcinoma. His body mass index was 22.5.


Results : We placed the patient in semi-flank position with the disease side up. The camera was at para-umbilical port for kidney dissection. During bladder cuff resection, we rotated the patient to Trendelenburg position, and used the subcostal port as the camera port. This instrument configuration enabled us to dissect the distal ureter and bladder cuff, and intracorporeal suturing for the bladder wound closure.


Conclusions :

Our approach for pure laparoscopic nephroureterectomy and bladder cuff resection is feasible for distal ureteral tumor. The advantages are less incisional wound, minimal blood loss and better visualization compared with conventional open method for bladder cuff manipulation.

Fan-Ching Hung

MD
Department of Urology, National Taiwan University Hospital
Taipei, Taipei, Taiwan (Republic of China)

Chi-Chih Lien

MD
Department of Urology, National Taiwan University Hospital
Taipei, Taipei, Taiwan (Republic of China)

Po-Ming Chow

MD
Department of Urology, National Taiwan University Hospital
Taipei, Taipei, Taiwan (Republic of China)

Hong-Chiang Chang

Chief
Urology, National Taiwan University
Taipei, Taipei, Taiwan (Republic of China)

Name: Hong-Chiang Chang
Present Title:
1. Associated Professor, Department of Urology, College of Medicine, National Taiwan University
2. Visiting Staff, Department of urology, National Taiwan University Hospital,
3. President, The Taiwanese Association of Andrology
4. Director, Taiwan Urology Association
Date of Birth : September 20, 1957
Sex: Male
Office Address : No. 7, Chung-Shan South Road, Taipei, Taiwan. Department of Urology, National Taiwan University, Taipei, Taiwan,
E-mail address: changhong@ntu.edu.tw
Citizenship: Taiwan, Republic of China
Education: M.D. (1976-1983), College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
Graduate Training and Experience:
1982-1983 Intership, National Taiwan University (NTU) Hospital
1983-1985 Physician in Air force military service,
1985-1989 Residency, Department of Urology, NTU Hospital.
1989-1995 Attending physician, Department of Urology, Provincial Taou-Yuang General Hospital, Taou-Yuang,Taiwan, R.O.C.
1995-now Attending Physician, Department of Urology, National Taiwan University Hospital
2001-2012 Clinical Assistant Professor, Department of Urology, Medical College, National Taiwan University.
2012-2015 Assistant Professor, Department of Urology, Medical college, National Taiwan University.
2014-2016 Chief, Department of Urology, National Taiwan University Hospital, hsin-Chu Branch, National Taiwan University