Hybrid laparoscopic ureteral reimplantation for the treatment of primary vesicoureteral reflux and obstructive megaureter

Laparoscopic ureteral reimplantation has gained increasing popularity in treating pediatric primary vesicoureteral reflux (VUR) and obstructive megaureter (OM). However, it is technically challenging with a relatively low success rate compared to open surgery. Here we designed a hybrid technique which incorporates laparoscopic surgery and pneumovesical ureteral reimplantation. From 2023 February to 2024 February, five boys and four girls underwent the hybrid reimplantation smoothly. There were seven children with VUR and two with OM. Patient age ranged from eight months to ten years. The mean time was 201.5 min (range 155-240 min) for unilateral operation and 260 min for bilateral operation. Follow-up ranged from 6.4 to 18.7 months. All patients remained asymptomatic, with voiding cystourethrogram showing cure or urinary ultrasonography showing significant improvement. In conclusion, the hybrid laparoscopic ureteral reimplantation appeared to be a simple and effective minimally invasive surgery for treating primary VUR and OM in children.