title: Laparoscopic pyeloplasty: a versatile alternative to open pyeloplasty.
abstract: 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.
authors.affiliation: Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. anees@sgpgi.ac.in
authors.forename: Aneesh
authors.initials: A
authors.lastname: Srivastava
authors.forename: Pratipal
authors.initials: P
authors.lastname: Singh
authors.forename: Ruchir
authors.initials: R
authors.lastname: Maheshwari
authors.forename: Mohd S
authors.initials: MS
authors.lastname: Ansari
authors.forename: Deepak
authors.initials: D
authors.lastname: Dubey
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
authors.forename: Anant
authors.initials: A
authors.lastname: Kumar
authors.forename: Anil
authors.initials: A
authors.lastname: Mandhani
mesh_terms: 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