Laparoscopic ureterocalicostomy for salvage of giant hydronephrotic kidney: initial experience

Reconstructive surgery for salvage of giant hydronephrosis is associated with unique challenges. We introduce the surgical technique of laparoscopic ureterocalicostomy for giant hydronephrosis. A transperitoneal five-port access was created and, after reflecting the colon, the lower pole of the hydronephrotic sac was excised. A wide, spatulated end-to-end ureterocaliceal anastomosis was performed. The sac was decompressed slowly in a controlled manner, which helped during dissection. At 3 months of follow-up, the patient was symptom free, and retrograde ureterography showed a wide, patent anastomosis. Laparoscopic ureterocalicostomy is technically feasible for the salvage of a giant hydronephrotic kidney and duplicates the results of open surgery.