title: Laparoscopic management of primary pelvi-ureteric junction obstruction: Single-centre experience.
abstract: OBJECTIVE
  To evaluate the effect and safety of laparoscopic pyeloplasty in the treatment of pelvi-ureteric junction obstruction (PUJO).
  
  
  METHODS
  In 34 patients, laparoscopic dismembered pyeloplasty was used to treat primary PUJO. Information was obtained for symptoms, results of a nuclear scan before and after surgery, intraoperative blood loss, operative duration, stenting method, and hospital stay. Under general anaesthesia and in the flank position, a 10 mm trocar was first placed above the umbilicus; three 5 mm working ports were then placed. The ureter and pelvis were freed from surrounding adhesions. The obstructive pelvi-ureteric segment was then excised, and the opened point of the ureter spatulated. Ureteropyeloplasty between the lower pole, pelvis and spatulated ureter was made using a 4-0 polyglactin suture around a JJ stent.
  
  
  RESULTS
  The mean (SD) preoperative nuclear scan result was 23.6 (6.4) mL/min, with retention of tracer. The median operative duration was 200 min, and the median blood loss 120 mL. All patients were stented with a JJ stent. The mean hospital stay was 5 days. The final results were assessed at 6 months after surgery, when the mean (SD) nuclear scan result was 30 (7.4) mL/min.
  
  
  CONCLUSIONS
  Laparoscopic pyeloplasty is a safe and effective option which can produce satisfactory results both clinically and radiologically.
authors.affiliation: Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Hani
authors.initials: H
authors.lastname: Nour
authors.affiliation: Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mostafa
authors.affiliation: Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Samir
authors.initials: S
authors.lastname: Gobashy
authors.affiliation: Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Hossam
authors.initials: H
authors.lastname: Elganzoury
authors.affiliation: Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Elkholy
authors.affiliation: Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Essam
authors.initials: E
authors.lastname: Riad
keywords: Laparoscopy; PUJO, pelvi-ureteric junction obstruction; Pelvi-ureteric junction obstruction; RALP, robot-assisted laparoscopic pyeloplasty