WOFAPS 2025 8th World Congress of Pediatric Surgery

Johana Paez, Daniela Moreno Villamizar, Camilo Orjuela, Yair Cadena

La Cardio Hospital, Colombia

Purpose: To present a laparoscopic uretero-ureterostomy in a pediatric patient with a right-sided duplex collecting system and preserved upper pole function.

Video method: We present step by step the laparoscopic uretero-ureterostomy for duplex systems in a pediatric patient. Informed consent was obtained.

We begin by placing a double-J stent in the ureter of the receiving system. Using 3-mm laparoscopic instruments, both ureters are carefully dissected and exposed. Percutaneous sutures are placed for optimal traction and exposure.

Longitudinal incisions are made in both ureters: the lower system ureter receives the side incision, and the upper system ureter the end incision. A side-to-end uretero-ureteral anastomosis is then performed. The anastomosis begins at the corners with interrupted 6-0 PDS sutures. The anterior wall is sutured using a running technique. To complete the posterior wall, a traction suture is placed on the upper system ureter to improve exposure, followed by a running suture with 6-0 PDS.

The distal upper system ureter is then ligated with a 12 mm Hem-o-lock clip. A closed suction drain is placed.

Results: The postoperative course was favorable, with no progression of urinary tract dilation, no infections, and no complications observed over one year of follow-up.

Conclusions: This is a minimally invasive, reproducible procedure with excellent outcomes when performed by an experienced team.