title: Laparoscopic ureteropyeloanastomosis in the treatment of duplex system.
abstract: OBJECTIVE
  Duplex system is one of the most common anomalies of upper urinary tract. Anatomical and clinical presentation determine its treatment. Usually, the upper moiety has a poor function and requires resection, but when it is not significantly impaired, preservation is recommended. Laparoscopic reconstruction with upper pole preservation is presented as an alternative treatment.
  
  
  METHODS
  Four female patients with duplex system, one presenting with recurrent urinary tract infection and the others with urinary incontinence associated to infrasphincteric ectopic ureter, were treated. Surgical procedure envolved a laparoscopic ureteropyeloanastomosis of the upper pole ureter to the pelvis of the lower moiety, with prior insertion of a double J stent.
  
  
  RESULTS
  Surgical time varied from 120 to 150 minutes, with minimal blood loss in all cases. Follow-up varied from 15 to 30 months, with resolution of the clinical symptoms and preservation of the upper moiety function.
  
  
  CONCLUSIONS
  Laparoscopic ureteropyeloanatomosis is a feasible and safe minimally invasive option in the treatment of duplex system.
authors.affiliation: Urologic Clinic, Hospital das Clinicas, University of Sao Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Hisano
authors.forename: Francisco T
authors.initials: FT
authors.lastname: Denes
authors.forename: Artur H
authors.initials: AH
authors.lastname: Brito
authors.forename: Marcos
authors.initials: M
authors.lastname: Lucon
authors.forename: Marcos G
authors.initials: MG
authors.lastname: Machado
authors.forename: Homero
authors.initials: H
authors.lastname: Bruschini
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D016896:Treatment Outcome; D014513:Ureter / Q000002:abnormalities / Q000601:surgery; D014551:Urinary Tract / Q000002:abnormalities* / Q000601:surgery; D014552:Urinary Tract Infections / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000601:surgery; D055815:Young Adult