Preliminary experience with ureteral intussusception in exclusive retroperitoneoscopic nephroureterectomy: a simple and safe option for the resection of the distal ureter and bladder cuff

To describe a surgical option in the resection of the distal third of the ureter and bladder cuff. Three nephroureterectomies were performed by the extraperitoneal access. The first was performed in a patient with vesicoureteral reflux, recurrent urinary infection and chronic renal failure; and two nephroureterectomies were performed for the treatment of upper urinary tract transitional cell cancer. Nephrectomy, according to the technique described by Gill, and treatment of the distal ureter were done based on the principles of open surgery, with exposure of the kidney by enlargement of one of the portals, sectioning the ureter, insertion of a catheter in the ureter antegradely of and eversion of the ureter endoscopically, followed by the removal of the bladder cuff. Among the techniques utilized for this procedure, we believe that the technique described herein presents some advantages because it does not require an incision for the removal of the distal ureter, it is easy to perform and provides more comfort to the patient after the surgery. Furthermore, only materials used by the urologist in routine practice are required and there is no contamination of the surgical space by neoplastic cells.