Surgical Maneuver for the Prevention of Ureteral Injuries

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Abstract
Approximately 1% of all pelvic operations result in iatrogenic ureteral injuries. Few reports in the literature give specific guidelines for their prevention. Intraoperative identification of the ureter has been advocated as the most reliable method of preventing ureteral trauma. The maneuver most commonly taught to residents consists of identification of the ureter in the medial aspect of the broad ligament. Because the ureter may be easily displaced by pathologic processes, the identification in this area may at times be difficult. An easier and more reliable maneuver, exposure of the ureter at the level of the common or external iliac artery, is described. This maneuver is easily taught and readily accepted by residents. (J GYNECOL SURG 5:291, 1989)