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Öğe Laparoscopic ureteroureterostomy for retrocaval ureter(Aves, 2010) Tepeler, Abdulkadir; Aktoz, Tevfik; Binbay, Murat; Muslumanoglu, Ahmet Yaser; Tefekli, Ahmet HamdiRetrocaval ureter is a rare congenital anomally with an approximate incidence of one in 1,000 live births. This anomally results from the atrophy failure of the posterior cardinal vein during development of the infarenal vena cava and leads to upper tract stasis and S or fishhook deformity of the ureter. It requires operative repair in the setting of functionally significant obstruction. Standart surgical correction involves excision of the retrocaval segment with relocation and ureteroureteral or ureteropelvic reanastomosis. Herein, a retrocaval ureter case managed with laparoscopic ureteroureterostomy is presented.Öğe Our Initial Experience with Retroperitoneoscopy(Galenos Yayincilik, 2009) Tok, Adem; Tepeler, Abdulkadir; Aktoz, Tevfik; Kaba, Mehmet; Akcay, Muzaffer; Binbay, Murat; Tefekli, Ahmet HamdiCurrent indications of retropentoneoscopy have been extended to oncologic operations and complex reconstructive procedures. We present our experience vvith retropentoneoscopy m 128 cases. Between 2003 and 2007 Pk retropentoneosopic procedures (61 nephrectomies 4 radical nephrectorny, 43 renal cyst resections, 1 heminephrectomy. 5 pyeloplasties, 7 unreterolithotomies. 2 pyelolithotomies. 3 partial nephrectomies. 1 adrenelectomy 1 nephrolithotomy) were performed in 128 patients (78 male, 50 female) with a mean age of 44.1 +/- 14.5 (range: 12-75`) years at our department. A canal was created through petit triangle, peritoneum was pushed medially try index finger and dissection of the retroperitoneal sPace was enabled by the balloon distension system. We classified 43 procedures (33%) as simple (cyst resctions), 81 (64%) as difficult (adrenalectomy, nephrectomy) and 4 (3%) as very difficult (partial nephrectomy, heminephrectomy). The mean operation time was 108 +/- 23.6 (range: 55-270) minutes depending on the difficulty of the procedure. The mean hospitalization period was 3.6 +/- 1.5 (range: 1-10) days. Major complications were not observed except vena cava inferior injury in one patient. Minor complications including fever (n=4) port-site infection (n: 3) were encountered in 5.4% (n=7). Blood transfusion was required in 4 cases. Open conversion was indicated in 3 cases due to xantagranulomatosis pyelonephritis (n=1). vena cava injury (n=1) and technical difficulties (n=1). Retroperitoneoscopy has proven to be an axcellent approach with certain advantages such as early control of renal hilurn, minimal risk of abdominal complication and feasibility in cases of previous abdominal surgery.Öğe Retrokaval üreter nedeniyle yapılan laparoskopik üreteroüreterostomi(2010) Tepeler, Abdülkadir; Aktoz, Tefvik; Binbay, Murat; Müslümanoğlu, Ahmet Yaser; Tefekli, Ahmet HamdiRetrokaval üreter, yaklaşık olarak her 1,000 canlı doğumda bir görülen nadir bir doğumsal anomalidir. İnfrarenal vena kavanın gelişimi sırasında posterior kardinal venin atrofiye uğramaması sonucu oluşur ve üst üriner sistemde basıya sebep olarak üreterde radyolojik olarak saptanan “S” veya “balık oltası” deformitesini oluşturur. Ciddi obstruksiyon varlığında cerrahi tedavi gerektirir. Standart cerrahi tedavide retrokaval seyreden ve basıya uğrayan kısım çıkarılarak yeniden üreter veya pelvise anastomoze edilir. Bu yazıda laparoskopik olarak üreteroüreterostomi yapılan bir retrokaval üreter vakası sunulmaktadır.