✦ VUR Treatment

Laparoscopic Extravesical Reimplantation (Lich-Gregoir)

Q: Why is the bladder not opened in this approach?

Lich-Gregoir creates the anti-reflux tunnel in the detrusor muscle outside the bladder, avoiding bladder entry and associated post-operative discomfort.

Q: Is laparoscopic reimplantation suitable for bilateral VUR?

Bilateral laparoscopic Lich-Gregoir carries higher voiding dysfunction risk; bilateral disease is often managed with open or robotic reimplantation. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: What is the success rate compared to open surgery?

Success rate exceeds 92% for unilateral VUR — slightly lower than open (95%) but with significantly reduced morbidity. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Minimally Invasive Extravesical Repair of Vesicoureteral Reflux

90–120 min PROCEDURE

1–2 Days HOSPITAL STAY

>92% SUCCESS RATE

2–3 Weeks RECOVERY

What is Laparoscopic Extravesical Reimplantation (Lich-Gregoir)?

Laparoscopic Extravesical Reimplantation using the Lich-Gregoir technique corrects VUR without opening the bladder. Through laparoscopic ports, the ureter is mobilised and a trough created in the detrusor muscle; the ureter is laid in the trough and the detrusor muscle closed over it, creating a submucosal tunnel without entering the bladder. This avoids bladder spasm and haematuria associated with intravesical approaches and provides excellent results with faster recovery. The procedure is performed under general or spinal anaesthesia with a hospital stay of 1–2 Days. Success rates reach >92% in appropriately selected patients at experienced centres.

Children and adults with unilateral VUR (grades III–IV) where minimally invasive surgery is preferred over open reimplantation. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Port Placement

Three to four laparoscopic ports placed; peritoneal space developed.

Detrusor Trough Creation

Ureterovesical junction identified; detrusor muscle incised creating a trough for the ureter.

Ureteric Positioning

Ureter mobilised and positioned in the detrusor trough.

Tunnel Creation

Detrusor muscle closed over the ureter creating an extravesical anti-reflux tunnel.

Closure

Bladder not opened; ports closed; no intravesical catheterisation needed in most cases.

Outcomes

90–120 minDURATION

1–2 DaysHOSPITAL STAY

>92%SUCCESS RATE

2–3 WeeksFULL RECOVERY

Who Needs This Treatment?

→Bladder not opened — eliminates bladder spasm and haematuria post-operatively.
→Shorter hospital stay than open reimplantation.
→Smaller incisions with excellent cosmetic result.
→Equivalent success rate to open for unilateral VUR.
→No bladder catheter required in most cases.
→Faster return to school and normal activity.

"The laparoscopic Lich-Gregoir technique gives us excellent VUR correction without entering the bladder. Less spasm, less haematuria, and faster recovery — with outcomes that rival open surgery."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Why is the bladder not opened in this approach?+

Is laparoscopic reimplantation suitable for bilateral VUR?+

What is the success rate compared to open surgery?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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