LAUSR

Video Objective To demonstrate methods to compensate for large ureteral defects after extensive resection of ureteral endometriosis. I will present 3 methods, the psoas hitch, the Boari flap and ileal interposition. Setting Urban general hospital in Japan. Interventions These patients suffered from ureteral stenosis, hydronephrosis and hydroureter. We performed laparoscopic extensive resection of DIE and the resection of the involved ureter. As a result of the resection, we needed reconstruction of the urinary tract. The type of reconstruction depends on the size of the defect. We need intact and tension-free anastomosis of the ureter and the bladder. If the involved segment is small, we perform simple reimplantation of the ureter to the bladder. However, if the defect is larger, we need to perform a psoas hitch and sometimes a Boari flap in accordance with how much length of the ureter needs to be compensated for. In rare cases where there is a great deal of loss of ureteral length, we interpose a graft of the ileum. The harvest defect of the ileum in reconstructed with functional end-to-end anastomosis. Conclusion The laparoscopic psoas hitch, Boari flap and ilieal ureter are reconstructive techniques that allow for more extensive resection of endometriosis by minimally invasive surgery. These techniques provide tension-free adaptation after extensive resection of the ureter.