Lessons from 90 consecutive laparoscopic dismembered pyeloplasties in a residency program

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Ureteropelvic junction obstruction is a common cause of flank pain and infection.
• Traditional open pyeloplasty can be associated with significant morbidity.
• Laparoscopic pyeloplasty offers a minimally invasive alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of laparoscopic pyeloplasty.
• To report outcomes of 90 consecutive cases performed at a university hospital.
• To assess complication rates and success in a residency training setting.

Main Methods:

• Retrospective review of 90 transperitoneal dismembered pyeloplasties performed between 2004 and 2010.
• All cases were for symptomatic ureteropelvic junction obstruction.
• Laparoscopic Anderson-Hynes technique with routine double-J stent placement was used.

Main Results:

• Mean operative time was 222.5 minutes.
• 96.6% of cases were completed laparoscopically; 3.3% required conversion.
• Major complications occurred in 4.4% of patients, with 87.3% showing symptomatic improvement at follow-up.

Conclusions:

• Laparoscopic pyeloplasty is a feasible procedure.
• High success rates and low complication rates are achievable.
• The technique is suitable for training programs and can be performed safely by residents.