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Related Experiment Videos

Dismembered V-flap pyeloplasty.

D A Diamond1, H T Nguyen

  • 1Department of Urology, Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

The Journal of Urology
|July 4, 2001
PubMed
Summary
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A modified dismembered V-flap pyeloplasty offers a successful approach for ureteropelvic junction obstruction. This technique provides advantages over traditional methods, ensuring excellent drainage and simpler repair for select patients.

Area of Science:

  • Urology
  • Pediatric Surgery
  • Surgical Techniques

Background:

  • Ureteropelvic junction (UPJ) obstruction is a common cause of pediatric kidney issues.
  • High ureteral insertion can complicate standard pyeloplasty repairs.
  • Reoperative cases present unique surgical challenges.

Purpose of the Study:

  • To introduce and evaluate a modified dismembered V-flap pyeloplasty technique.
  • To assess its suitability for primary and reoperative repair of UPJ obstruction with high ureteral insertion.

Main Methods:

  • A V-flap of the renal pelvis was created by dividing and incising the ureteropelvic junction.
  • The flap was spatulated and approximated to the ureter.
  • The procedure was performed on 12 patients (2 reoperative, 10 primary) aged 3 months to 17 years.

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  • Radiological evaluations (renal scan, excretory urography) were conducted pre- and postoperatively.

    • Main Results:

    • All 12 patients demonstrated excellent drainage post-procedure.
    • Radiological assessments at 3 months and 1 year confirmed successful outcomes.
    • No complications related to the V-flap technique were reported.

    Conclusions:

    • Dismembered V-flap pyeloplasty is a successful and advantageous technique for select UPJ obstruction cases.
    • It avoids tissue tension, unnecessary mobilization, and offers a dependent, funneled configuration.
    • The technique simplifies repair while combining benefits of dismembered and flap pyeloplasties.