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Stenting Antegrade Via Veress Needle during Laparoscopic PyeloplastY ("SAVVY" Technique)
Ramesh Babu1, Apurva Arora1, Niranjan Raj1
1Department of Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
Aim:
The aim of the study is to report the outcomes of different stenting techniques during laparoscopic pyeloplasty (LP).
Materials And Methods:
This study was a retrospective audit of duration of stenting, complications encountered, and operative outcomes of LP in children older than 3 years.
Results:
Retrograde cystoscopic prestenting took significantly longer time (17.2 min) and the presence of stent hindered in anastomosis. Antegrade stenting without guide wire took longer time (9.6 min), and in some, there was difficulty in negotiating distal ureter. Antegrade stenting over guide wire, through a 14-gauge intravenous cannula, took significantly less time (7.3 min) although the cannula got kinked and the stenting was difficult in some as the length of the cannula was short and it did not reach anastomotic site. "Stenting Antegrade Via Veress needle during laparoscopic pyeloplastY" ("SAVVY" technique) favored by authors has the least stenting duration (4.8 min) and minimum failures (P = 0.01, ANOVA). The needle is wide enough to pass a 4-Fr stent and long enough to reach the anastomotic site.
Conclusion:
SAVVY technique saves time during LP with least failures and is a useful stenting technique in children.