Retroperitoneal laparoscopic dismembered pyeloplasty: experience with 50 cases

Area of Science:

• Urology
• Minimally Invasive Surgery
• Pediatric Surgery

Background:

• Ureteropelvic junction (UPJ) obstruction is a common cause of pediatric hydronephrosis.
• Surgical correction is often necessary to restore proper urine flow.
• Traditional open pyeloplasty can be associated with significant morbidity.

Purpose of the Study:

• To present the techniques and outcomes of retroperitoneal laparoscopic dismembered pyeloplasty for UPJ obstruction.
• To evaluate the efficacy and safety of this minimally invasive approach.

Main Methods:

• A retroperitoneal, three-port, balloon-dissecting approach was utilized.
• Laparoscopic dismembered pyeloplasty was performed in 50 patients.
• Intracorporeal suture techniques were employed for all anastomoses.
• Follow-up included intravenous urography and renal ultrasonography.

Main Results:

• All 50 procedures were completed laparoscopically without open conversion.
• Mean operative time was 81.6 minutes, with mean blood loss of 12 mL.
• Mean postoperative hospital stay was 7.6 days.
• 49 out of 50 patients showed good radiographic results at a mean follow-up of 22 months.
• Two patients experienced anastomotic leakage, with one requiring revision surgery.

Conclusions:

• Retroperitoneal laparoscopic dismembered pyeloplasty is a safe and effective treatment for UPJ obstruction.
• This minimally invasive technique can be performed efficiently with favorable patient outcomes.
• The approach offers a viable alternative to open surgery for UPJ obstruction.