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Related Experiment Videos

Laparoscopic Fenger plasty.

G Janetschek1, R Peschel, G Bartsch

  • 1Department of Urology, University of Innsbruck, Austria. Guenter.Janetschek@elizabethinen.or.at

Journal of Endourology
|February 24, 2001
PubMed
Summary
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Laparoscopic nondismembered pyeloplasty is a highly effective treatment for ureteropelvic junction obstruction, achieving a 98% success rate in long-term follow-up. This minimally invasive approach is preferred over dismembered pyeloplasty for most cases.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Pediatric Surgery

Background:

  • Ureteropelvic junction (UPJ) obstruction in adults can be caused by intrinsic stenoses or crossing vessels.
  • Laparoscopic nondismembered pyeloplasty is the standard surgical approach for these conditions at our institution.

Purpose of the Study:

  • To present the long-term outcomes of laparoscopic nondismembered pyeloplasty for UPJ obstruction.
  • To evaluate the efficacy and safety of this minimally invasive technique.

Main Methods:

  • A retrospective review of 67 patients (34 female, 31 male) aged 11-77 years who underwent laparoscopic nondismembered pyeloplasty between 1994 and 1999.
  • Preoperative and postoperative evaluations included IV urography, isotope scans, and color Doppler ultrasonography to identify crossing vessels.

Related Experiment Videos

  • Surgical correction involved Fenger or Y-V plasty after displacing obstructing vessels, with a 6-week indwelling stent.

    • Main Results:

    • The mean operative time was 123 minutes with no intraoperative complications.
    • Ventrally crossing vessels were identified and displaced in 79% of patients.
    • The overall success rate was 98%, with a single failure due to a long, infection-aggravated stenosis. Mean follow-up was 25 months.

    Conclusions:

    • Laparoscopic nondismembered pyeloplasty is a highly successful and preferred method for managing UPJ obstruction.
    • Dismembered pyeloplasty is reserved for rare, complex cases.
    • The technique demonstrates excellent long-term results and a high success rate.