Pelvi-ureteric junction obstruction with crossing renal vessels: a case report of failed laparoscopic vascular hitch.
BACKGROUND
Dismembered pyeloplasty has been the traditional technique in the management of pelvi-ureteric junction obstruction (PUJO) secondary to crossing renal vessels in children. Laparoscopic transposition of lower pole vessels for PUJO has been described in children as well as adults.


METHODS
We report a child with PUJO secondary to lower pole renal vessels who underwent laparoscopic transposition of vessels. The child had persistent PUJO, which was later treated with laparoscopic dismembered pyeloplasty.


CONCLUSIONS
Laparoscopic transposition of renal vessels is a simple technique, and requires less operating time. It involves no anastomosis or insertion of temporary DJ stent. However, as of now there are no imaging techniques or intraoperative procedures available to confirm that the crossing renal vessels are the sole etiology for PUJO. This option should therefore be used with caution.
Nerli
R B
RB
Department of Urology, KLES Kidney Foundation, Belgaum 590010, India. rbnerli@yahoo.com
Jayanthi
V Rama
VR
Reddy
Mallikarjun
M
Koura
Ashish
A
D000792:Angiography; D002648:Child; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D014513:Ureter / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods