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Updated: May 22, 2026
03:57
Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Scarless pyeloplasty in the pediatric population
1Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. paul.noh@cchmc.org
Urology
|May 15, 2012
Summary
This study shows that pediatric laparoscopic pyeloplasty (LP) without instrument trocars is safe and effective. The modified technique leads to excellent cosmetic results and improved hydronephrosis, promoting scarless surgery.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Pediatric pyeloplasty is a common procedure for ureteropelvic junction obstruction.
- Traditional laparoscopic pyeloplasty utilizes multiple instrument trocars.
- A modified technique avoiding instrument trocars may offer cosmetic and clinical benefits.
Purpose of the Study:
- To evaluate the outcomes of a modified pediatric laparoscopic pyeloplasty (LP) technique performed without the use of instrument trocars.
- To assess the safety, efficacy, and cosmetic results of this novel approach.
Main Methods:
- Retrospective cohort study of pediatric patients undergoing LP without instrument trocars.
- Review of patient demographics, surgical details, complications, and clinical outcomes.
- Utilized a single trocar for insufflation and laparoscope, with 3-mm instruments introduced via skin punctures.
Main Results:
- Ten procedures were performed on nine pediatric patients (median age 8 months).
- All procedures were completed without open conversion, intraoperative complications, or need for reoperation.
- Demonstrated improved hydronephrosis on follow-up ultrasound, excellent cosmetic outcomes, and short hospital stays.
Conclusions:
- Laparoscopic pyeloplasty without instrument trocars is a safe and effective alternative.
- This technique offers excellent cosmetic results and clinical benefits with minimal narcotic use and short hospital stays.
- Intermediate-term follow-up suggests this approach facilitates scarless surgery in pediatric patients.
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