title: One-trocar-assisted pyeloplasty: An attractive alternative to open pyeloplasty.
abstract: BACKGROUND
  To survey the effects of one-trocar-assisted pyeloplasty (OTAP) in the treatment of ureteropelvic junction obstruction (UPJO) in kids.
  
  
  METHODS
  Forty-four children (±3.5 years) were submitted to OTAP procedure. A flank incision under the XII rib was made, the Gerota's fascia was achieved and a balloon Hasson trocar with an operative telescope inserted for retroperitoneal access. The renal pelvis and ureter were isolated and exteriorised. Forty-two patients underwent Anderson-Hynes dismembered and one Fenger pyeloplasty . One patient was converted to an open procedure. Two patients presented an aberrant crossing vessel. In all patients, a double J stent was positioned. The operative time and length of stay (LOS) were evaluated. Renal scan and ultrasound (US) were utilised to evaluate the results from 6 to 12 months.
  
  
  RESULTS
  OTAP was successful in all but 1 patient. Mean operative time and LOS were 128 min and 3,5 days. We had four operative complications (9.09%). The US and a nuclear scan confirmed the resolution of the UPJO in all patients except one with the Fenger pyeloplasty who had an open Anderson-Hynes.
  
  
  CONCLUSIONS
  The combination of retroperitoneoscopic and open procedures for dismembered pyeloplasty offers a simple, time-saving method in a minimally invasive fashion with low morbidity for patients with UPJO.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marte
authors.affiliation: Department of Paediatrics and Paediatric Surgery, Second University of Naples, Caserta, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Papparella
mesh_terms: D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D061646:Operative Time; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012187:Retroperitoneal Space / Q000601:surgery; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation*