A New Touchless Technique for Suturing in Transperitoneal Laparoscopic Pyeloplasty

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Laparoscopic pyeloplasty (LPP) involves critical steps like ureteral spatulation and anastomosis.
• These steps can be time-consuming, technically demanding, and risk ureteral shortening.
• Minimizing ureteral manipulation is crucial for successful outcomes.

Purpose of the Study:

• To present a modified dismembered technique for laparoscopic pyeloplasty.
• To simplify critical suturing steps in LPP.
• To evaluate the outcomes of LPP using this modified technique.

Main Methods:

• A transperitoneal dismembered Anderson-Hynes LPP approach was used in 23 patients.
• The ureter was partially cut and spatulated laterally, with the renal pelvis obliquely incised.
• Anastomosis was achieved using running sutures after initial stitch placement.

Main Results:

• The study reported a 96% radiologic success rate.
• No intraoperative organ injuries or conversions to open surgery occurred.
• One patient required nephrectomy due to a nonfunctional obstructive kidney.

Conclusions:

• The modified technique preserves total ureteral length and simplifies spatulation and suturing.
• This method facilitates transperitoneal laparoscopic dismembered pyeloplasty.
• The technique is beneficial, especially for surgeons with less experience in LPP.