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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Laparoscopic pyeloplasty in secondary obstruction
Artur Henrique Brito1, Anuar Ibrahim Mitre, Miguel Srougi
1Division of Urology, University of São Paulo Medical School, São Paulo, Brazil.
Journal of Endourology
|January 12, 2008
Summary
Laparoscopic pyeloplasty effectively treated secondary ureteropelvic junction (UPJ) obstruction in 92.3% of patients. This minimally invasive approach offers a viable alternative to open surgery for complex UPJ cases.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Secondary ureteropelvic junction (UPJ) obstruction can arise from various prior interventions.
- Management of recurrent or complex UPJ obstruction presents surgical challenges.
- Laparoscopic pyeloplasty is increasingly utilized for UPJ obstruction.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopic pyeloplasty for secondary UPJ obstruction.
- To assess outcomes in patients with UPJ obstruction secondary to previous failed procedures.
Main Methods:
- A retrospective review of 13 patients with symptomatic secondary UPJ obstruction who underwent laparoscopic transperitoneal pyeloplasty.
- Analysis of causes of obstruction, operative details, complications, and follow-up data.
- Intraoperative antegrade Double J stent placement in all cases.
Main Results:
- Successful laparoscopic pyeloplasty in 12 out of 13 patients (92.3%).
- Mean operative time of 195 minutes and a mean hospital stay of 2.2 days.
- No conversions to open surgery or intraoperative complications were reported; insignificant blood loss.
Conclusions:
- Laparoscopic pyeloplasty is a safe and effective treatment for secondary UPJ obstruction.
- Outcomes are comparable to primary laparoscopic pyeloplasty and open surgical repair.
- Laparoscopic correction represents a favorable alternative for complex UPJ obstruction cases.
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