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S28-13
(P)
SURGEON PERFORMED ULTRASOUND FOR STENT POSITION IN LAPAROSCOPIC
PYELOPLASTY
Stephen ADAMS, Costa HEALY, Sengamalai MANOHARAN, Stephen GRIFFIN and Henrik STEINBRECHER
Southampton Children's Hospital, Paediatric Urology, Southampton, UNITED KINGDOM
INTRODUCTION
We currently place a JJ stent antegradely at laparoscopic pyeloplasty. Several methods are described for proving the
distal end of the stent reaches the bladder, including fluoroscopy or placing methylene blue in the bladder, these both
have significant disadvantages. We aimed to determine whether surgeon performed ultrasound scan can reliably confirm
that a JJ-stent has reached the bladder.
METHODS
Prospective data collection from Dec 2013-Jan 2015. Portable ultrasound (Sonosite TM) was used to evaluate the stent
position peri-operatively either at primary operation or at stent removal.
RESULTS
Thirteen patients, median age 10 (Range 5-15 years) were included. Eight scans were performed at insertion and 5 at
retrieval. In 11 patients (85%) the end of the JJ stent was correctly identified in the bladder (confirmed at operative
retrieval). In the other 2 patients the stent could not be confidently identified in the bladder and this was initially
attributed to body habitus or technical difficulties, however in neither case was the stent to be found in the bladder and
both required ureteroscopic removal.
CONCLUSIONS
We have found surgeon performed peri-operative ultrasound to be reliable in determining that the stent has reached the
bladder when performing laparoscopic pyeloplasty in children. When the ultrasound did not clearly demonstrate the
stent lying within the bladder this proved to be a true negative finding in both cases.
We recommend surgeon performed ultrasound as a reliable non-ionising modality to confirm good stent position at
laparoscopic pyeloplasty. When there is uncertainty, then further investigation such as fluoroscopy is indicated.