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Laparoscopic pyeloplasty for ureteropelvic junction obstruction (UPJO) is complex, with Canadian urologists showing varied techniques and comfort levels. This study highlights the need for shared procedural insights to improve surgical outcomes.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery

Background:

  • Ureteropelvic junction obstruction (UPJO) is a common cause of urinary obstruction.
  • Laparoscopic pyeloplasty has become the preferred surgical approach for UPJO in adults and adolescents.
  • Significant variability exists in the technical execution of laparoscopic pyeloplasty.

Purpose of the Study:

  • To assess the current practices and comfort levels of Canadian urologists regarding laparoscopic pyeloplasty.
  • To identify factors influencing surgeon comfort and procedural variability in laparoscopic pyeloplasty.

Main Methods:

  • An online survey was distributed to urologists registered with the Canadian Urology Association (CUA).
  • The survey collected data on training, comfort, techniques, and stenting practices for laparoscopic pyeloplasty.

Main Results:

  • 100 urologists responded, with most preferring the dismembered Anderson-Hynes technique.
  • Procedural steps showed considerable variability among respondents.
  • Higher annual procedure volume and institutional case volume correlated with greater surgeon comfort.

Conclusions:

  • Laparoscopic pyeloplasty is technically demanding, leading to discomfort among some Canadian urologists.
  • Further discussion and sharing of procedural tips are needed to enhance surgeon confidence and standardize techniques.