Laparoscopic ureteroplasty using onlay appendix flap: a case series

Abstract Background Currently, strictures of the ureters often develop after endourology of the upper urinary tract, gynecological, and surgical interventions. For long proximal ureteral strictures, ureteroplasty with an on-lay appendix flap may be an option for treatment. Case presentation Five patients had laparoscopic onlay appendicoureteroplastic for long right ureter strictures. The average age of the patients was 42.5 years old. Four patients developed a stricture after transurethral contact ureterolithotripsy; one patient had it after laparoscopic ureterolysis. The average stricture length was 3.5 (2.8–5.2) cm. The length of the stricture was controlled, including using near-infrared fluorescence imaging. With an average observation time of 14.6 (6.2–28.4) months, the operation was effective in all patients. The urodynamics of the upper urinary tract recovered completely in three patients and comparatively improved in two patients. All of the patients stopped feeling any pain. The observed patients were saved from external and internal drainage. Conclusions Laparoscopic onlay ureteroplasty with an appendix in a selected group of patients may be the method of choice for long strictures of the middle and upper parts of the right ureter.