The authors present an interesting modification of the pluck technique by circumcision of the orifice during or before laparoscopic nephroureterectomy. The intraureteral injection of collagen glue (Tisseel) may occlude the distal ureter and avoid tumor cell spillage. The concept was tested clinically by intraoperative intravenous injection of indigo carmine. After sufficient occlusion, the ureter appears dilated and blue in color.There is no doubt, that this technique is much easier than the transvesical approach placing a loop around the distal ureter as described by Gill et al. It seems also more appropriate than the transurethral placement of a hem-o-lock clip after transurethral dissection of the ureteral orifice. Moreover, the exact circumcision and dissection of the distal ureter might be more precise than a laparoscopic bladder cuff, be it thermofused or stapled
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