CPT® Code 50947

Laparoscopy, surgical ureteroneocystostomy with cystoscopy and ureteral stent placement is a minimally invasive surgical procedure that involves the re-implantation of the ureter into the bladder. This technique is performed using a laparoscopic approach, which allows for smaller incisions and reduced recovery time compared to traditional open surgery. The procedure begins with the creation of a small incision below the umbilicus, through which a trocar is inserted to access the peritoneal cavity. A laparoscope is then introduced to provide visualization of the internal structures. The abdomen is insufflated to create a working space for the surgeon. Additional incisions are made to allow the introduction of surgical instruments necessary for the procedure. During the surgery, the ureter is carefully mobilized, starting from the area proximal to the broad ligament down to the ureterovesical junction. An incision is made in the bladder's muscular wall, known as the detrusor muscle, to form a trough at the site where the ureter will be reattached. The ureter is then inserted into this trough, and the edges of the detrusor muscle are sutured around the ureter to secure it in place. Following the ureteroneocystostomy, cystoscopy is performed, which involves inserting a cystoscope through the urethra into the bladder to visualize the ureteral opening. A guidewire is advanced into the ureter, and a ureteral stent is placed over the guidewire to ensure proper drainage and support of the ureter during the healing process. The procedure concludes with the placement of a urethral catheter, removal of the cystoscope and laparoscope, and closure of the abdominal incisions.