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Amy L. Halverson and David C. Borgstrom (eds.)Advanced Surgical Techniques for Rural Surgeons10.1007/978-1-4939-1495-1_3131. Preoperative Ureteral Catheter Placement to Prevent Ureteral Injuries
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Department of Surgery, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA
Indications
During major pelvic surgery, ureteral injury is always a concern. Pelvic abscesses, sigmoid colectomy for recurrent diverticulitis, and colectomy for ulcerative colitis are only some examples of surgeries where inflammation and loss of normal anatomic planes make a ureteral injury even more difficult to avoid. Preoperative ureteral catheter placement is a relatively straightforward procedure that allows for tactile recognition of the ureter during open pelvic surgery. Lighted stents may be used in open as well as laparoscopic surgery. These give the ureter a faint glow, providing visual identification of the ureter intraoperatively.
Preoperative Preparation
Ureteral Catheter Placement
If the surgeon is planning for ureteral catheter placement, it is imperative that a preoperative urine culture be obtained showing no growth, preferably in the 2 weeks prior to surgery.
Ureteral catheter placement is performed with the anesthetized patient in the dorsal lithotomy position with the genitalia prepped and draped in standard sterile fashion. Fluoroscopy is useful to guide catheter placement and is considered essential by some to safely insert the catheter. The surgeon will need the following:
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