Laparoscopic treatment of bilateral duplex kidney and ectopic ureter: A case report

Figure 3 Intraoperative imaging. A-F show left ureter operation, and G-L show right ureter operation. The operation process of right and left side was similar. A: The peritoneum was cut beside the iliac artery; B: Two parallel ureters on the left side were found and dissociated; C: The ectopic ureter was cut off, and the broken end was trimmed. The 1.5 cm ureter was turned out in sleeve shape to form "nipple"; D: A 5 Fr ureteral stent (D-J tube) was inserted through the broken end of the ureter; E: The bladder was filled with 200 mL normal saline through the catheter. Then the ectopic ureter was completely released from the pelvic peritoneal, the lateral posterior wall of the bladder was fully incised about 1.0 cm, and the urine in the bladder was sucked out. Then, the ureteral "nipple" was completely inserted into the bladder through the incision of the lateral posterior wall of the bladder. Finally, 4-0 absorbable suture was used to intermittently suture the bladder incision and ureteral "nipple", with a total of 4-6 stitches. One or two stitches were used to reinforce the bladder seromuscular layer; F: 4-0 absorbable suture was used to continuously suture the pelvic peritoneal incision, and the bladder ureteral anastomosis was wrapped outside the peritoneum.