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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
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Retroperitoneoscopic dismembered pyeloplasty for pelvi-ureteric junction obstruction in infants and children

C K Yeung1, Y H Tam, J D Sihoe

  • 1Division of Paediatric Surgery, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong. ckyeung@cuhk.edu.hk

BJU International
|April 12, 2001
PubMed

Insights

Retroperitoneoscopic dismembered pyeloplasty is a safe and effective minimally invasive procedure for pediatric pelvi-ureteric junction obstruction. This technique offers good early outcomes in infants and children, with rapid recovery.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Pelvi-ureteric junction (PUJ) obstruction is a common congenital anomaly in children.
  • Traditional open pyeloplasty has been the gold standard, but minimally invasive techniques are gaining traction.
  • Retroperitoneal laparoscopic approaches offer potential advantages in terms of cosmesis and recovery.

Purpose of the Study:

  • To evaluate the initial experience and outcomes of retroperitoneoscopic dismembered pyeloplasty in infants and children.
  • To assess the safety and efficacy of this minimally invasive technique for PUJ obstruction.

Main Methods:

  • Retrospective review of 13 infants and children undergoing retroperitoneoscopic dismembered pyeloplasty for PUJ obstruction.
  • Patients underwent the procedure in a semi-prone or semi-lateral position.
  • A 5-mm laparoscope was used to perform the dismembered pyeloplasty with a double-pigtail ureteric stent.

Main Results:

  • Successful retroperitoneoscopic dismembered pyeloplasty in 12 out of 13 patients (92.3%).
  • One patient required open conversion due to difficulties in retroperitoneal space development.
  • Mean operative time was 143 minutes, with rapid and uneventful recovery and satisfactory drainage on follow-up scans.

Conclusions:

  • Retroperitoneoscopic dismembered pyeloplasty is an effective and safe surgical option for pediatric PUJ obstruction.
  • The procedure demonstrates good early outcomes in infants and young children.
  • Long-term results require further investigation.
Abstract

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