# Initial Experience with Laparoscopic Ureteroplasty with a Spliced Appendiceal Mucosal Graft for Proximal Ureteral Stricture

## TL;DR

This paper describes a new laparoscopic technique using a spliced appendiceal mucosal graft to repair difficult-to-treat proximal ureteral strictures, with promising initial results.

## Contribution

The first reported series of laparoscopic ureteroplasty using a spliced appendiceal mucosal graft for proximal ureteral stricture repair.

## Key findings

- The novel technique was successfully performed in three patients without converting to open surgery.
- All patients showed reduced hydronephrosis and no obstruction after a minimum 12-month follow-up.
- No major intraoperative or postoperative complications were observed.

## Abstract

Long-segment proximal ureteral strictures present a significant surgical challenge, particularly in patients unwilling or unsuitable for an oral mucosal graft. Here we report the first series of laparoscopic ureteroplasty procedures with a spliced appendiceal mucosal graft (SAMG) for proximal ureteral stricture. The novel technique was performed successfully in all three patients without conversion to open surgery. The mean operative time was 178.3 min, mean estimated blood loss was 36.7 ml, and mean hospital stay was 5.6 d. The postoperative follow-up period was at least 12 mo, and all patients exhibited a reduction in hydronephrosis and no obstruction of the reconstructed ureteral segments. There were no major intraoperative or postoperative complications. SAMG ureteroplasty appears to be a safe and effective surgical method for repair of proximal ureteral stricture.