title: A modified suture technique for transperitoneal laparoscopic dismembered pyeloplasty of pelviureteric junction obstruction.
abstract: OBJECTIVE
  To describe a modified suture technique for transperitoneal laparoscopic dismembered pyeloplasty (TPLDP) that can be consistently replicated.
  
  
  METHODS
  Between June 2010 and April 2014, 21 men and 7 women with primary pelviureteric junction obstruction underwent our modified TPLDP suture technique performed by the same surgeon. In our method, the dismembering should be performed after performing half of anastomosis to achieve the maintenance of correct orientation and the prevention of torsion of anastomosis. We defined the success criteria as complete clinical resolution of flank pain for the patients with flank pain and complete radiologic resolution for the asymptomatic patients.
  
  
  RESULTS
  The mean overall operative time for our technique was 137.3 minutes. The mean operative time for procedures on the left side was longer than on the right side (P = .02). The mean suture time was 37.2 minutes. The mean estimated blood loss was 29.4 mL, and the crossing vessel was found in 7 of 28 patients (25.0%). No open conversion was required. The mean follow-up time was 21.0 months. Only 1 patient still had frequent and intolerable flank pain after surgery whose treatment was unsuccessful. The rest of the patients got complete clinical or radiologic resolution. The success rate was 27 of 28 (96.4%).
  
  
  CONCLUSIONS
  Our modified TPLDP suture technique is feasible and seems to be safe and to allow high success rate for the treatment of pelviureteric junction obstruction. Sizable sample and further analysis about technique will be completed in the future.
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Kunlin
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China. Electronic address: pineneedle@sina.com.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Cuijian
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Fang
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
authors.forename: Zhisong
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China. Electronic address: zhouliqunmail@sina.com.
authors.forename: Liqun
authors.initials: L
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital* / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult