Application of Polymer Clip to Ligate the Distal Ureter in Retroperitoneal Laparoscopic Radical Nephroureterectomy

Purpose: ： Distal ureter management in radical nephroureterectomy (RNU) is challenging. Methods: : This study describes a simple endoscopic clip technique with polymer clip ligation for the management of the distal ureter during retroperitoneal laparoscopic RNU. This endoscopic technique was used in 14 patients with upper tract urothelial carcinoma (UTUC). Transurethral resection of the bladder cuff was performed using a bipolar β electrode (mounted on resectoscope). Subsequently, a Super Scope (S-scope) with a 5-mm-diameter dual working channel was used with clip applier to deliver the polymer clips, which consequently ligated the ureteral stump and avoided urine spillage from the upper tract. Results: : Distal ureter was managed successfully in all 14 cases using polymer clip, without any cases of urine spillage. Conclusions: : Therefore, polymer clip ligation technique provides a simple and safe option for distal ureter management in retroperitoneal laparoscopic RNU.