LAPAROSCOPIC CORRECTION OF VESICOURETERAL REFLUX

Major advances have been made in the area of laparoscopic surgery. The advantages of this approach include smaller incisions, shorter hospit alizations, a more rapid convalescence and decreased postoperative dis comfort. To explore the technical feasibility of performing antireflux surgery laparoscopically, we conducted a pilot study in 4 mini-pigs i n which bilateral vesicoureteral reflux had been created surgically. W e applied a modification of the Lich extravesical ureteral approach to perform laparoscopic antireflux surgery. All mini-pigs underwent succ essful unilateral mobilization, creation of a bladder wall trough and creation of a new ureteral tunnel laparoscopically. Examinations were performed postoperatively, and then serially at 1, 2, 3 and 5 months a fter repair. Fluoroscopic cystograms demonstrated the resolution of re flux in the corrected ureters and persistence of reflux in the uncorre cted control ureters in all animals. Excretory urography showed no evi dence of obstruction. Laparoscopic correction of vesicoureteral reflux appears to be technically feasible in the animal model. Long-term fol lowup is necessary to determine the possible applicability of this tec hnique in humans.