Protect the Ureters

From 7/1/2006 to 6/30/2007 151 patients with complex pelvic pathology underwent placement of lighted ureteral stents by a general surgeon (JR) or gynecologist (SM). None of the patients had a ureteral injury that underwent pre-procedure ureteral stent placement. The procedures included laparoscopic colorectal surgery for diverticular disease(33 patients(pts), colon or rectal cancer(12pts), pelvic endometriosis(endo) with or without hysterectomy(34pts) , reoperative gynecologic(gyn) disease (i.e. Ovarian remnant, endo)(15pts) or adhesion related disease of the pelvis (57pts) The average time from placement of the stents to start of the operation was 5 minutes (2-15 minutes) No complications occurred from the stents. In 6 patients the stents could not be placed and all had ureteral pathology that was NOT noted pre-op. Two patients had ureter injuries at our hospital that did not have ureteral stents placed in the same time period. The cost of the stents is $209. OR time past the first ½hour ranges from $560 to $716 for each additional ½ hour. The time saved from the lighted identification of the ureters versus visual non stent identification is from zero minutes to taking as long as 45 minutes for ureter identification without stents or waiting over 60 minutes for an on call urologist. This is an extremely useful procedure that can theoretically reduce ureter injury to zero. In an era where insurance will not pay for complications related to the original operation; this procedure should be the standard of care for safely performing complex pelvic surgery.

Session: Poster

Program Number: P363

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