title: Laparoscopic pyeloplasty using endoscopic GIA stapler for ureteropelvic junction obstruction.
abstract: OBJECTIVE
  We applied laparoscopic pyeloplasty in 10 patients with ureteropelvic junction (UPJ) obstruction. To evaluate the efficiency and safety of this procedure using an endoscopic GIA stapler, the clinical outcomes and our procedures are presented.
  
  
  METHODS
  From August 1996 to March 2003, eight female and two male patients with a mean age of 22.3 years suffering from UPJ obstruction diagnosed by various combinations of ultrasonography, excretory urography, retrograde ureteropyelography, CT, and MRI were treated with laparoscopic dismembered Anderson-Hynes pyeloplasty with resection of a dilated redundant renal pelvis. In six cases, an endoscopic gastrointestinal automatic stapler (Endo-GIA) was used. The procedure was performed via an extraperitoneal approach in two cases and a transperitoneal approach in eight.
  
  
  RESULTS
  Laparoscopic pyeloplasty was successful in all patients, including the six treated using an Endo- GIA stapler. The mean operating time was 291 minutes, and the mean anastomotic time was 105 minutes, with a mean estimated blood loss of 44 mL. Postoperative complications occurred in five cases: anastomotic urinary leakage in two and pyelonephritis in three. The mean time to full convalescence in the entire series was 22 days. No urolithiasis occurred in the patients treated with the Endo-GIA stapler during the follow-up period of 2 to 76 (mean 22) months.
  
  
  CONCLUSIONS
  Laparoscopic dismembered pyeloplasty including the Endo-GIA stapler technique is an efficient and safe procedure that provides excellent results for extrinsic or complicated UPJ stenosis. The risk of stone formation has not yet been determined.
authors.affiliation: Department of Urology, Nagoya University Graduate School of Medicine, Tsurumai, Nagoya, Japan. h-araki@h7.dion.ne.jp
authors.forename: Hidemori
authors.initials: H
authors.lastname: Araki
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Ono
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.forename: Momokazu
authors.initials: M
authors.lastname: Goto
authors.forename: Tokunori
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Toru
authors.initials: T
authors.lastname: Kimura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ohshima
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017792:Surgical Stapling; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery*; D018666:Ureteroscopy