Prophylactic Ureteric Catheterization with Illuminated Ureteric Stent during Difficult Laparoscopic Colorectal Surgeries

Background: The close proximity of ureters to the colon and rectum, ureteric injury is a potential complication in colorectal surgery. Incidence of iatrogenic ureteric injury ranges from 1 to 10%. Aim: The aim of this study is to evaluate the operative time, the efficacy in preventing iatrogenic ureteric injuries and the complications associated with prophylactic illuminated ureteric catheterization in the difficult laparoscopic colorectal surgeries. Materials and methods: Twenty-two patients who underwent difficult laparoscopic colorectal surgery from 2009 to 2011 in Department of General Surgery in SCB Medical College Hospital, Cuttack, were included in the study. The ureteric catheterizations were cystoscopically performed by using number 5 French illuminated ureteric catheter. Results: The use of ureteric catheters added a mean of 20 minutes to the total surgical procedure time. Postoperative complications oliguria or anuria not seen. Urinary tract infection seen in one patient which makes the incidence of 4.5% in our study. There was no ureteric injury during surgery. Average hospital stay was 6 days. Overall cost did not alter. There were no cases of conversion to laparotomy in our study. Conclusion: With negligible morbidity, the use of illuminated ureteric stents ensure ureteric safety in complex cases by direct visualization of the ureteric position throughout the dissection, especially in laparoscopic surgeries. Iatrogenic ureteric injuries and conversion to laparotomies are minimized by using illuminated ureteric stent.