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Cost-effective laparoscopic pyeloplasty: single center experience.
Ashok Kumar Hemal1, Rajiv Goel, Apul Goel
1Department of Urology, All India Institute of Medical Sciences, New Delhi, India. akhemal@hotmail.com
Summary
Cost-effective laparoscopic pyeloplasty (LPP) for ureteropelvic junction (UPJ) obstruction offers a minimally invasive approach. This study demonstrates LPP
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Ureteropelvic junction (UPJ) obstruction is a common cause of pediatric and adult kidney issues.
- Laparoscopic pyeloplasty (LPP) presents a minimally invasive surgical option for UPJ obstruction.
- Open pyeloplasty is the traditional treatment, but LPP offers potential benefits.
Purpose of the Study:
- To report the single-center experience of performing cost-effective laparoscopic pyeloplasty (LPP) in 24 patients.
- To evaluate the safety, efficacy, and cost-efficiency of LPP for UPJ obstruction.
Main Methods:
- LPP was performed on 24 patients (17 male, 7 female; age 8-51 years) between 1999 and 2002.
- Both transperitoneal (n=12) and retroperitoneal (n=12) approaches were utilized.
- Cost-reductive measures included indigenous balloon dissectors, reusable ports, standard sutures, and intracorporeal suturing.
Main Results:
- Successful LPP was achieved in 23 out of 24 patients, with one conversion to open surgery.
- Mean operative times and hospital stays were comparable between retroperitoneal and transperitoneal groups.
- No major complications were observed, with a low rate of obstruction recurrence (1/21 patients).
Conclusions:
- Laparoscopic pyeloplasty (LPP) is a safe, effective, and minimally invasive alternative to open pyeloplasty for UPJ obstruction.
- LPP provides durable results comparable to open surgery.
- Cost-efficient techniques allow for the safe and effective performance of LPP.