Abstract Purpose Ureteral reimplantation is a known surgical option for various distal ureteral anomalies. While the open approach is still the gold standard, laparoscopic approach is gaining popularity although technically challenging, and results may vary depending on the approach and the surgeon's experience. The video presented shows an extrapolation of the Shanfield principle in the laparoscopic approach in pediatric ureteric reimplantation.Materials and methods A 4-year-old girl, with a left obstructing, refluxing megaureter was managed initially with an endoureterotomy which failed. Following this unsuccessful attempt, a distal ureterostomy was performed to temporize followed by a Shanfield ureteric reimplant. The procedure was done using three 5 mm ports with the primary port being transumbilical. Ureteral mobilization and taking down of the stoma were done followed by an extra-mucosal detrusorotomy of about 1.5–2 cm on the postero-lateral bladder wall above the trigone. The prolapsed mucosa is grasped through this window and incised to create a small opening into the bladder. The spatulated ureter is advanced through the window to the interior of the bladder, and its lower end is anchored to the trigone 1–2 cm distal to the detrusorotomy wound with an appropriate size (3/0 or 4/0) PDS suture in a U-stitch fashion. With this manouvre, the ureter is towed to the interior of the bladder and anchored. The detrusorotomy is closed over loosely, forming a very short sub-mucosal tunnel. Cystofix 5Fr and urethral catheter 10Fr is inserted at the end of the procedure.Results At 6-months follow-up, the patient is asymptomatic and infection-free with resolution in upper tract dilatation.Conclusion Shanfield anastomotic technique appears to be safe and effective when applied to ureteric reimplantation.
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