LAPAROSCOPIC CORRECTION OF VESICOURETERAL REFLUX IN THE PIG

Extravesical detrusorrhaphy is a modification of the Lich-Gregoir anti reflux procedure that incorporates ureteral advancement into the repai r. We report on our use of laparoscopic detrusorrhaphy to correct vesi coureteral reflux in an animal model. Reflux was created by transureth ral incision of the roof of each ureteral orifice. In phase 1 of this study, laparoscopic repair was performed 1 week later in 3 pigs and an open technique was done in the remainder. In phase 2 laparoscopic rep air was done in 3 pigs 3 weeks after inducing vesicoureteral reflux. A ll phase 1 repairs successfully corrected reflux but 1 ureter in the l aparoscopic group developed obstruction. All phase 2 repairs were succ essful, which was determined by preoperative and postoperative cystogr aphy, and a postoperative excretory urogram. Average time was 2 hours 21 minutes for laparoscopic repair and 1 hour 10 minutes for the open procedure. Complications included bladder perforation and ureteral obs truction in 1 case each with no postoperative deaths. These preliminar y results indicate that laparoscopic detrusorrhaphy is a feasible proc edure in a porcine model.