[Laparoscopic pyeloplasty in pediatric patients: our experience]

The aim of this essay is to present our initial experience with laparoscopic pyeloplasty and highlight how some specific technical changes allowed us to improve our results. We performed a chart review of the patients that underwent laparoscopic pyeloplasty in our institution. We included patients older than 6 months old with proved stenosis of the ureteropelvic junction. We compared our first patients with the last ones in which we performed laterocolic approach in all left pyeloplasties and included a modification of the technique to place an external ureteric stent. We performed 13 laparoscopic pyeloplasties, 8 male patients and 5 female. There were 3 right pyeloplasties (23%) and 10 left ones (77%). We performed transmesocolic approach in 2 cases (left) and laterocolic approach in 11. Mean surgical time was 184 minutes in the first 8 cases and 142 in the 5 last ones. We had three cases of complications in the first group, two stents migrated to ureter and one postsurgical infection. In the last cases we had a postoperative bleeding. Laparoscopic approach is an effective option for pyeloplasty with similar results to those of the open approach in spite of a longer surgical time. Experience and specific surgical details allow us to reduce complication rate and surgical time.