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Updated: Mar 24, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
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Laparoscopic Pyeloplasty: Always Dismembered?

José Heriberto Amón Sesmero1, Marcos Cepeda Delgado1, Beatriz de la Cruz Martín1

  • 1Urology Department, Hospital Universitario Río Hortega (HURH) , Valladolid, Spain .

Journal of Endourology
|March 16, 2016
PubMed
Summary

Laparoscopic pyeloplasty techniques, including Anderson-Hynes (A-H) and Hellström technique (HT), offer effective treatment for ureteropelvic junction obstruction (UPJO). The Hellström technique demonstrated reduced operating time and hospital stay with comparable success rates.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Pediatric Surgery

Background:

  • Ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis in children and adults.
  • Laparoscopic pyeloplasty has become a preferred surgical approach for UPJO due to its minimally invasive nature.
  • Several laparoscopic techniques exist, each with potential advantages and disadvantages.

Purpose of the Study:

  • To compare the efficacy, safety, and operative parameters of three laparoscopic surgical techniques for UPJO.
  • To assess the difficulty, operating time, success rates, and complication profiles of Anderson-Hynes (A-H) pyeloplasty, nondismembered pyeloplasty, and the Hellström technique (HT).

Main Methods:

  • A retrospective review of 54 patients undergoing laparoscopic pyeloplasty for UPJO between 2003 and 2013.

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  • Procedures included A-H pyeloplasty (n=34), nondismembered pyeloplasty (n=11), and HT (n=9), with technique selection based on intraoperative findings.
  • Outcomes were compared using statistical analyses, with success defined by symptom absence and normal diuretic renography.

    • Main Results:

    • Success rates were high across all techniques: 88.5% for A-H, 90.9% for nondismembered, and 100% for HT (p>0.05).
    • The HT group showed significantly shorter operating times (124 min vs. 202 min for A-H, p<0.005) and hospital stays (3.42 days vs. 6.7 days for A-H, p<0.05).
    • Postoperative complication rates were comparable (21.1% A-H, 18.8% nondismembered, 12.5% HT, p>0.05), with urinary fistula being the most common.

    Conclusions:

    • Intraoperative assessment allows for effective selection of laparoscopic pyeloplasty techniques, including nondismembered approaches.
    • Nondismembered pyeloplasty techniques can achieve results similar to A-H pyeloplasty.
    • Laparoscopic pyeloplasty, particularly the HT, offers reduced operative time, complication rates, and hospital stay for UPJO treatment.