MaterIal anD MethoDs

Introduction. Vesicoureteral reflux (VUR) is a common symptom of various functional and morphological abnormalities. When appropriate conservative and endoscopic treatments are employed, surgical management is recommended in a progressively less frequent pattern. Failure of such treatment modalities may be an indication for surgical treatment. The methods that are used can be divided into those that require incision of the abdominal integuments to access the bladder and ureter and those that are performed using videoscopic techniques. Among therapeutic modalities used in VUR treatment, there is an extravesicular VUR repair using the method developed by Lich and Gregoir. The authors would like to present this technique based on three surgical correction cases and their results. Material and methods. The above-mentioned transperitoneal technique was performed on three girls aged 7-10 years with grade III vesicoureteral reflux because the previously employed conservative and endoscopic treatment failed to achieve VUR correction. Under general anesthesia, cystoscopy was performed preoperatively to evaluate bladder abnormalities, such as periureteral diverticula, and to place a 4.8 Fr. or double “J” ureteral splint. Four ports were used to perform the operations. The average surgical time was 180 minutes. results. The surgery and postoperative course were uneventful. Seven days postoperatively, the patients were discharged. Voiding cystography performed 3-4 months after surgery demonstrated the absence of reflux. Conclusions. In the preliminary assessment, extravesicular laparoscopic procedures can be performed without any intraor postoperative complications. The presented results point to the effectiveness of the method.