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Related Experiment Video

Updated: May 22, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

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Published on: July 8, 2025

Coagulum pyelolithotomy "revisited" by laparoscopy: technique modification.

Ricardo Borges¹, Paulo Azinhais, Edson Retroz

¹Urology Department, General Hospital, Centro Hospitalar Universitário Coimbra, EPE, Coimbra, Portugal. rlgborges@gmail.com

|May 8, 2012

Summary

This summary is machine-generated.

This modified laparoscopic technique improves stone removal during ureteropelvic junction obstruction repair. It effectively extracts small, mobile stones often missed by traditional methods, enhancing surgical outcomes.

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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Published on: November 22, 2019

Area of Science:

Urology
Minimally Invasive Surgery
Endourology

Background:

Laparoscopic ureteropyeloplasty is a standard treatment for ureteropelvic junction (UPJ) obstruction.
Concomitant stone burden, especially small, mobile stones, presents technical challenges during this procedure.
Classic coagulum pyelolithotomy has limitations in laparoscopic settings.

Purpose of the Study:

To describe a modified coagulum pyelolithotomy technique using fibrin sealant for laparoscopic UPJ obstruction with stones.
To evaluate the efficacy of this modified technique in facilitating stone removal.

Main Methods:

A laparoscopic transperitoneal dismembered ureteropyeloplasty with modified coagulum pyelolithotomy was performed.
Key steps include urine aspiration, injection of fibrin sealant and methylene blue, coagulum formation, UPJ excision, and stone extraction.
Pelvic reduction, ureter spatulation, and double-J stent placement followed.

Main Results:

The modified technique successfully extracted a tenacious coagulum containing stones.
The volume of stones removed often exceeded preoperative imaging predictions.
This method proved effective in managing small, mobile stones within the renal pelvis.

Conclusions:

This fibrin sealant-based coagulum pyelolithotomy is an effective modification for laparoscopic UPJ repair.
It significantly reduces incomplete stone removal in cases with multiple small, free stones.
The technique enhances stone clearance and improves overall surgical success in complex UPJ obstructions.