Total Laparoscopic Hysterectomy with Ureteral Stent Placement
Ureteral injury during gynecological surgery is a common problem and prevention is very much required. After the advent of laparoscopy iatrogenic ureteral injury during gynecological surgery has increased and it is associated with increased morbidity when not diagnosed during the initial surgery.
Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach.
Using Infrared Ureteric Catheter Is beneficial as it will decrease the ureteric injury. Ureteric catheterization may facilitate prompt recognition of ureteral injury during the initial procedure, which is associated with early repair and decreased morbidity.
In women who sustained a ureteral injury during a laparoscopic hysterectomy, a percutaneous nephrostomy need to be performed and they underwent surgical repair during a separate hospitalization several weeks later.
It is true that there are inherent risks of ureteral catheterization, including perforation, transient edema and obstruction, but literature search supported a low incidence of these complications.
The decision to perform universal cystoscopy or ureteral catheterization during a total laparoscopic hysterectomy should be based on a number of factors. When thinking about cost‐effectiveness, laparoscopic surgeons should consider their personal ureteral injury rate overall in hysterectomy surgery and the risk any specific patient might carry based on her history or pathology.
We believe that ureteral catheterization should be considered for cost savings in patient undergoing a benign laparoscopic total or radical hysterectomy.
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