Dr Ali Thwaini.

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A 70 year old healthy gentleman presented with an impacted left upper ureteric stone. The initial stone treatment was successful, however the stone impaction resulted in a long mid-ureteric stricture.

Many conservative treatments with variable stents (including JJ stents and Memokath) were attempted and faced failure due to severe encrustation and stent related symptoms.

The patient was referred to Dr Ali Thwaini, a consultant urologist at Mediclinic City Hospital, who counselled him for a laparoscopic repair of his ureter by replacing the diseased segment with a piece of his small bowel. This procedure is normally carried out in a traditional open surgery, lasting several hours and needing a large abdominal incision, with a prolonged post-operative recovery.

The laparoscopic approach offsets most of these challenges by offering minimal invasive surgery and quicker post-operative recovery.

The patient consented for the procedure and it went smoothly.  He stayed for four days in the hospital and went home afterwards in a good condition. He returned to his duties in a very short time.

Upon follow up, the patient was doing very well and back to normal within four weeks of the surgery.

To our knowledge, this is one of the first procedures of this type to be carried out in the UAE, and it provides a viable and long term alternative to the other existing treatment methods.