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Updated: Jul 13, 2026
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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Adult stentless laparoscopic pyeloplasty
Arieh L Shalhav1, Albert A Mikhail, Marcelo A Orvieto
1Section of Urology, University of Chicago Pritzker School of Medicine, Chicago, Illinois 60637, USA.
Summary
Laparoscopic stentless pyeloplasty (LSP) offers a promising, effective treatment for adult ureteropelvic junction obstruction (UPJO). This initial study shows successful outcomes without the need for ureteral stents, simplifying the procedure.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrology
Background:
- Ureteropelvic junction obstruction (UPJO) is commonly treated with open or laparoscopic pyeloplasty.
- Nonstented pyeloplasty has primarily been documented in pediatric cases.
- Laparoscopic stentless pyeloplasty (LSP) in adults remains largely unexplored.
Purpose of the Study:
- To report the initial experience of laparoscopic stentless pyeloplasty (LSP) in adult patients with UPJO.
- To evaluate the safety and efficacy of LSP in this population.
- To assess functional outcomes using renal scan data.
Main Methods:
- A prospective study included adult patients with UPJO and a normal contralateral kidney.
- Dismembered pyeloplasty was performed laparoscopically without ureteral stent placement.
- Postoperative outcomes were assessed via Tc-99m MAG3 renal scans, complication monitoring, and long-term follow-up.
Main Results:
- Five adult patients underwent LSP with a mean follow-up of 15.7 months.
- The procedure demonstrated favorable perioperative metrics: mean operative time 196 minutes, blood loss 58 mL, and hospital stay 1.6 days.
- All patients experienced symptom resolution, and renal scans confirmed improved urinary drainage, with no major complications reported.
Conclusions:
- Laparoscopic stentless pyeloplasty (LSP) appears to be an effective and safe treatment option for adult UPJO.
- Experienced surgeons may consider LSP as a viable alternative to stented pyeloplasty.
- Further research is warranted to confirm these initial findings in larger cohorts.