Combined Rectosigmoidectomy with Ureterectomy and Ureteral Reimplantation by Videolaparoscopy – Technical Details

Introduction Locally advanced colon neoplasms with invasion of adjacent organs can often pose a challenge for achieving R0 surgery using minimally invasive techniques. Sigmoid lesions may invade organs of the genitourinary tract, and to achieve free margins, resection may be necessary, and, when indicated, reconstruction, as in the case of urinary tract invasion.

Objectives Technical description of rectosigmoidectomy with the need for ureterectomy in a patient with an advanced sigmoid tumor, where ureteral reimplantation was performed in the psoic bladder.

Methods A 74-year-old patient presented with abdominal pain and diarrhea. Colonoscopy identified a neoplastic lesion in the sigmoid. Staging exams showed no evidence of distant disease. A laparoscopic resection was planned, and during the inventory, left ureter adhesion to the tumor was identified. Ureterectomy was performed, followed by laparoscopic ureteral reimplantation using a modified Lich-Gregoir technique.

Results The rectosigmoidectomy combined with ureteral reimplantation was successfully performed, achieving free margins. The patient had no complications from the procedure and was referred for adjuvant chemotherapy.

Conclusion Resection of organs and structures adhered to the tumor is crucial for obtaining an oncologically adequate result, and performing the entire procedure via minimally invasive surgery facilitates a faster recovery for the patient.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025