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Laparoscopic Ureteric tapering and Extravesical Ureteric reimplantation by Dr Shashikant Mishra

Salient features of this operation. 1. All three 5 mm port, 5 mm for camera and two additional 5 mm port for dissection and retraction. 2. Preplacement of glide wire before hand for preparing the ureter for tapering. 3. No dismemberment of ureter before to falicitate ureteric tapering while maintaining the natural traction. 4. Bladder mobilization and traction with silk sutures at dome for medial reflection of the wall. 5. Dissection of the detrussor and bladder mucosa. Cystotomy made at distal end of the dissection. Detrussor tunnel can later be done easily. 6. All sutures vicyrl 4,0 passed from the abdominal skin avoiding narrow route through 5 mm port. 7. 6/20 DJ stent passed though pediatric cystoscope after completing the mucosal anastomosis before detrussoraphy.

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