The Utility of Lighted Ureteral Stents in Laparoscopic Colorectal Resection: A Survey of Canadian Surgeons

BACKGROUND: Establishing the exact location of the ureters is critical in preventing ureteric injury during colorectal surgery. In laparoscopic colorectal resections this identification can be facilitated by the pre-operative insertion of lighted ureteral stents (LUS). LUS may also serve as an invaluable educational aid during the teaching of colorectal surgery. However, the available evidence does not support the routine use of stents as an injury prevention measure. Furthermore, stent insertion carries inherent risks of ureteric injury. The objective of this study was to determine the frequency of use and indications for LUS in laparoscopic colorectal resections among Canadian surgeons. METHODS: A seven-question survey was administered to Canadian surgeons through the monthly Canadian Association of General Surgeons (CAGS) e-news over a period of three months. The questions focused on surgeon demographics, experience with laparoscopic colon resections and the use of stents. RESULTS: Seventy-five surgeons completed the survey. There was a wide range of experience among the surgeons in terms of years in practice. The majority (84%) reported performing laparoscopic colorectal resections and of those 65% reported performing less than 25 resections a year. Only 26% of surgeons used LUS during laparoscopic resections. Furthermore, 75% of LUS users did not have sub-specialty training, 69% performed less than 25 resections per year and 50% were in practice for less than five years. When used, LUS were inserted for diverticular disease (100%), left colon resection (88%) and low anterior resections (75%). CONCLUSION: The majority of surgeons across Canada do not use LUS for laparoscopic colorectal resections. Of those performing laparoscopic colorectal resections, there may be a preference to use LUS for complex cases and by novice operators. This data suggests that proponents of LUS deem that it may have a role in diverticular disease.