Eur J Pediatr Surg 2013; 23(02): 143-147
DOI: 10.1055/s-0032-1329708
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Extravesical Ureteral Reimplantation (LEVUR): A Multicenter Experience with 95 Cases

Mario Riquelme
1   Department of Pediatric Surgery, Christus-Muguerza Hospital, Monterrey, Mexico
Manuel Lopez
2   Department of Pediatric Surgery, University Hospital, St. Etienne, France
Sergio Landa
3   Department of Pediatric Surgery, La Raza IMSS Hospital, Mexico City, Mexico
Francisco Mejia
4   Department of Pediatric Surgery, Pablo Tobon Hospital, Medellin, Colombia
Arturo Aranda
5   Department of Surgery, Wright State University, Dayton, Ohio, United States
Mario Rodarte-Shade
6   Department of Surgery, Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
Jaime Rodriguez-Gomez
7   Department of Surgery, Universidad de Montemorelos, Monterrey, Nuevo Leon, Mexico
Jairo Torres-Riquelme
7   Department of Surgery, Universidad de Montemorelos, Monterrey, Nuevo Leon, Mexico
› Author Affiliations
Further Information

Publication History

01 February 2012

18 August 2012

Publication Date:
19 November 2012 (online)


Introduction Minimally invasive techniques have been used to treat vesicoureteral reflux (VUR) on pediatric patients. The aim of this study is to review the experience of the laparoscopic approach for VUR by the laparoscopic extravesical ureteral reimplantation (LEVUR) Lich-Gregoir technique.

Materials and Methods We performed a multicentric retrospective study. From 2001 to 2009, 81 pediatric patients with VUR constituting 95 ureteral units underwent LEVUR. Reflux was grade II in 32%, grade III in 55%, and grade IV in 8%.

Results LEVUR was performed successfully on the 81 patients with 95 ureteral units. Mean operative time was 105 minutes for left-sided reimplants, 70 minutes for right sided, and 180 minutes for bilateral reimplants. Mean hospital stay was 1.6 days. Urinary catheter was kept in place for a mean time of 0.5 days. Follow-up was achieved for at least 1 year with regular clinic visits, urinalysis, ultrasound, and voiding cystourethrogram. Four patients (4.2%) had evidence of recurrent VUR in a follow-up of 6 to 36 months after antireflux surgery.

Conclusions Although new endoscopic techniques have been widely available for VUR, they have a lower success rate and might require multiple attempts before success. We report that LEVUR has an acceptable success rate (95.8%) and durability compared with open and endoscopic procedures.


This paper was presented as an oral presentation at the Ist World Congress of Pediatric Urology, San Francisco, California, USA, May 2010

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