Laparoscopic pyeloplasty: a versatile alternative to open pyeloplasty.
OBJECTIVE
To report the safety, efficacy and versatility of laparoscopic pyeloplasty (LPP) in treatment of pelviureteric junction obstruction (PUJO).


METHODS
From January 2002 to November 2006, 185 patients (186 units; 182 with primary and 4 with secondary PUJO) underwent LPP (transperitoneal approach in 184; retroperitoneal approach in 2). A double J stent was placed antegradely in 121 (68.4%) units, cystoscopically in 50 units (28.2%), and 6 units (3.4%) were stentless. Patients were followed up clinically, with additional diuretic renogram.


RESULTS
Surgery was completed laparoscopically in 177 units, and conversion was required in 9 (4.8%) units. Pyeloplasty was dismembered in 143 units, Foley YV plasty in 26 units, and Fenger pyeloplasty in 8 units. The median estimated blood loss, operative time and hospital stay were 50 ml, 180 min and 4 days, respectively. Overall, 18 (9.6%) patients had complications. Improvements in drainage patterns of 167 out of 177 units (94.3%) were shown on a renal scan at a median follow-up of 39 months (range: 3-63 months).


CONCLUSIONS
LPP is a safe, effective and versatile method for treatment of PUJO, which is applicable to all age groups, even in the presence of secondary stones, crossing vessels and secondary PUJO.
Srivastava
Aneesh
A
Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. anees@sgpgi.ac.in
Singh
Pratipal
P
Maheshwari
Ruchir
R
Ansari
Mohd S
MS
Dubey
Deepak
D
Kapoor
Rakesh
R
Kumar
Anant
A
Mandhani
Anil
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*; D055815:Young Adult