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Simplified approach to percutaneous endopyelotomy.

S J Savage¹, S B Streem

¹Cleveland Clinic Foundation, Cleveland, Ohio, USA.

|November 9, 2000

Summary

This study introduces a novel percutaneous antegrade endopyelotomy technique using primary stent placement for precise incisions. This method simplifies the procedure and reduces risks, achieving an 83% success rate in patients.

Area of Science:

Urology
Minimally Invasive Surgery

Background:

Percutaneous antegrade endopyelotomy is a standard treatment for ureteropelvic junction obstruction.
Traditional techniques can involve risks such as ureteropelvic junction disruption during stent placement.

Purpose of the Study:

To describe a novel, safe, simple, and rapid percutaneous antegrade endopyelotomy approach.
To detail a technique involving primary stent placement before the endopyelotomy incision.

Main Methods:

The endopyelotomy stent is placed first, defining the incision site.
An acorn-tipped Bugbee electrode is used for the incision, guided by the stent.
This approach is analogous to ureteral meatotomy.

Main Results:

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The procedure was performed on 38 patients, with 29 having follow-up.

Success, defined by symptom resolution and decreased calicectasis, was achieved in 24 of 29 patients (83%).

The technique facilitated precise incisions and avoided large-caliber stent passage post-incision.

Conclusions:

Primary stent placement and electrocautery facilitate a precise percutaneous antegrade endopyelotomy.
This modified technique offers a safe and effective alternative for treating ureteropelvic junction obstruction.