ČESKÁ UROLOGIE / CZECH UROLOGY – 4 / 2019

294 VIDEO Ces Urol 2019; 23(4): 292–294 managed with laparoscopic access. This is the first report in the Czech literature. Material and method: A 12 years-old girl pre‑ sentedwith recurrent attacks of right-sided flank pain of two weeks duration, associated with vomiting. Ultrasound showed right hydronephrosis and dilata‑ tion of the upper part of the right ureter. Intravenous urography showed a typical ureteral „S shaped de‑ formity“ suggesting retrocaval ureter. CT urography confirmed the diagnosis and the patient was sched‑ uled for laparoscopic transperitoneal reconstruction. The girl was placed under general anesthesia. A Foley catheter was inserted and the patient placed in a lateral decubitus position. A 10mm laparoscopic port was placed at the umbilicus and two 5 mm working ports were placed under direct vision in the midline above and below the umbilicus. The peritoneumwas opened lateraly to ascending colon and retroperitoneal space was exposed. Then, the dilated pelvis and dilated proximal ureter was iden‑ tified and dissected down to vena cava. The lower ureter was partially mobilised and the retrocaval segment was entirely separated fromvena cava. The lower part of dilated pelvis was stabilized with a stay suture and pelvis was divided up to pyeloureteral junction. The ureter was repositioned to lie anterior to the vena cava and a retrocaval part of the ureter was excised. A standard laparoscopic dismembered pyeloureterostomy using two 5/0 Vicryl continous sutures was performed, protected by a 6 French 28 cmdouble J stent inserted through abdominal wall under ribs. Drain was not inserted, Haemolog clips were used to close peritoneum. Results: The operating time was 237 min and blood loss was minimal (< 25 ml). The girl recov‑ ered uneventfully. On the postoperative 4 th day, the urethral catheter was removed and the patient was discharged on the 5 th day postoperatively. Stent re‑ moval was done 7weeks later. Ultrasoundperformed 3,5months after reconstruction confirmed complete resolution of right renal pelvic and ureteric dilatation. Conclusion: Laparoscopic transperitoneal ap‑ proach of retrocaval ureter is a safe and feasible alternative to standard open access. It provides well known advantages associated withminimally inva‑ sive surgery. KEY WORDS Laparoscopy, retrocaval ureter, child, urinary ob‑ struction. Soutěž ČUS o nejlepší video publikované v časopise Česká urologie Soutěž ČUS Všechna videa publikovaná v časopise Česká urologie v roce 2019 budou do soutěže zařazena automaticky Podmínkou zařazení je, že první autor bude urolog Vítězné práce budou vyhlášeny na Výroční konferenci ČUS 2020 Následně budou výsledky zveřejněny v časopisu Česká urologie a na webových stránkách ČUS 2019