Page 20 - WALS Journal

WJOLS

10.5005/jp-journals-10033-1161
Prophylactic Ureteric Catheterization with Illuminated Ureteric Stent during Difficult Laparoscopic Colorectal Surgeries
ORIGINAL ARTICLE
Prophylactic Ureteric Catheterization with Illuminated

Ureteric Stent during Difficult Laparoscopic

Colorectal Surgeries

Manash Ranjan Sahoo, T Anil Kumar

ABSTRACT Ureteric stents can be of great help if ureter identification
difficulty is anticipated. The use of illuminated ureteric
Background: The close proximity of ureters to the colon and
rectum, ureteric injury is a potential complication in colorectal stents adds another dimension to ensure ureteric safety in
surgery. Incidence of iatrogenic ureteric injury ranges from complex cases by giving direct visualization of the ureteric
1 to 10%.
position throughout the dissection. 1
Aim: The aim of this study is to evaluate the operative time, the
efficacy in preventing iatrogenic ureteric injuries and the AIM
complications associated with prophylactic illuminated ureteric
catheterization in the difficult laparoscopic colorectal surgeries. The aim of this study is to evaluate the operative time, the
Materials and methods: Twenty-two patients who underwent efficacy in preventing iatrogenic ureteric injuries and the
difficult laparoscopic colorectal surgery from 2009 to 2011 in complications associated with prophylactic ureteric
Department of General Surgery in SCB Medical College catheterization with illuminated ureteric stents in the
Hospital, Cuttack, were included in the study. The ureteric
catheterizations were cystoscopically performed by using difficult laparoscopic colorectal surgeries.
number 5 French illuminated ureteric catheter.
Results: The use of ureteric catheters added a mean of MATERIALS AND METHODS
20 minutes to the total surgical procedure time. Postoperative Twenty-two patients who underwent difficult laparoscopic
complications oliguria or anuria not seen. Urinary tract infection
seen in one patient which makes the incidence of 4.5% in our colorectal surgery from 2009 to 2011 in Department of
study. There was no ureteric injury during surgery. Average General Surgery in SCB Medical College and Hospital,
hospital stay was 6 days. Overall cost did not alter. There were Cuttack, were included in this retrospective study.
no cases of conversion to laparotomy in our study.
All patients who underwent laparoscopic colorectal
Conclusion: With negligible morbidity, the use of illuminated surgery were assessed. Patient variables that were analyzed
ureteric stents ensure ureteric safety in complex cases by direct
visualization of the ureteric position throughout the dissection, included surgical indications, history of prior abdominal
especially in laparoscopic surgeries. Iatrogenic ureteric injuries surgery, time from induction of anesthesia to surgical
and conversion to laparotomies are minimized by using incision (preparation time), total operative and total
illuminated ureteric stent.
anesthesia times (beginning of stent insertion to completion
Keywords: Laparoscopic, Colorectal surgery, Ureteric injuries, of surgery) and postoperative morbidity.
Illuminated ureteric catheters.
All ureteric catheters were tested for illumination before
How to cite this article: Sahoo MR, Kumar TA. Prophylactic surgery (Fig. 1). All ureteric catheterizations were
Ureteric Catheterization with Illuminated Ureteric Stent during
Difficult Laparoscopic Colorectal Surgeries. World J Lap Surg
2012;5(3):113-115.

Source of support: Nil
Conflict of interest: None declared

INTRODUCTION

Proximity of ureters to the colon and rectum, ureteric injury
is a potential complication in colorectal surgery, especially
in advanced carcinoma, previous surgery, radiation which
displaces the ureter, eventually making the identification
difficult.
Incidence of iatrogenic ureteic injury ranges from 1 to
10%. Most injuries occur during rectal and sigmoid
mobilization. Fig. 1: Illuminating ureteric stent
World Journal of Laparoscopic Surgery, September-December 2012;5(3):113-115 113