Termino-Terminal Ureteral Laparoscopic Anastomosis in a Case of Deep Infiltrating Endometriosis

Abstract Objective Laparoscopic termino-terminal ureteral anastomosis has all the advantages of a minimally invasive approach plus the treatment of the pathology. Ureteral deep endometriosis can lead to severe consequences, such as hydroureteronephrosis and renal failure. The main objective of this video is to present our surgical strategy and technique for cases of ureteral deep infiltrating endometriosis, which could help to understand and perform this surgery in a safer way for the patients. Design Video demonstration of the technique. Setting French university tertiary care hospital Intervention This video presents a termino-terminal laparoscopic ureteral anastomosis and shows our team strategy for a 42 years old woman with a deep infiltrating ureteral left endometriosis, with the consequent stenosis and left hydroureteronephrosis. A full resection of the endometriotic ureteral nodule was realize, followed by a termino-terminal anastomosis of the ureter. The use of intravenous indocyanine green to assess the post anastomotic ureteral perfusion and its risk of leakage or fistula are described in the video. Conclusion Ureteral endometriosis can lead to severe consequences, the surgical treatment can be difficult and most of the times incomplete. This video is a detailed example of our team strategy to perform a termino-terminal ureteral laparoscopic anastomosis in a structured way.