Movie: Laparoscopic pelvic side wall dissection of the ureter
The ureter is the narrow tube which joins the kidneys to the bladder. Although the ureter is a retro-peritoneal structure, its course in the pelvis is close to the ovaries with the result that any ovarian surgery carries the risk of ureteric injury. Laparoscopy, in fact, usually provides a much better view of the course of the pelvic ureter than is the case at laparotomy (open surgery), but if there is scarring or adhesions, the ureter may be difficult to identify. In such cases, we usually open up the pelvic side wall peritoneum and dissect down until we can see the ureter moving, and thereby minimize the risk of injury during gynaecological surgery.