Laparoscopic ureteric reimplantation (extravesical)

Major advances have been made in the area of laparoscopic surgery since the 1980s. The advantages of this approach include smaller incisions, shorter hospitalizations, a more rapid convalescence, and decreased postoperative discomfort. Laparoscopic antireflux surgery was first described using a modification of the Lich extravesical ureteral approach (Atala et al. 1993; Ehrlich et al. 1994; Lich et al. 1961). Other techniques for laparoscopic ureteral reimplantations, including modifications of the Lich technique (a muscle wrap, an extraperitoneal approach) as well as the use of the Cohen cross-trigonal technique, have also been described (Cohen et al. 1999; Gill et al. 2001; Sakamoto et al. 2003). In this chapter, we describe the Lich extravesical approach, being that it is the most commonly used technique for laparoscopic ureteral reimplantation.