Transumbilical single-incision hybrid pyeloplasty for infant ureteropelvic junction obstruction

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Ureteropelvic junction obstruction (UPJO) is a common cause of congenital hydronephrosis in infants.
• Traditional pyeloplasty techniques have varying success rates and cosmetic outcomes.
• The need for effective, minimally invasive surgical options for infant UPJO is ongoing.

Purpose of the Study:

• To present a novel hybrid pyeloplasty technique for treating UPJO in infants.
• To evaluate the safety, efficacy, and cosmetic results of this hybrid approach.
• To compare this technique with existing pyeloplasty methods.

Main Methods:

• A hybrid pyeloplasty technique was developed, combining elements of laparoendoscopic single-site surgery and open pyeloplasty.
• The procedure was performed through a single umbilical incision.
• Seven infants diagnosed with UPJO underwent the hybrid pyeloplasty.

Main Results:

• All seven infants tolerated the hybrid pyeloplasty procedure well, with a mean operative time of 131.9 minutes.
• Follow-up (11.8-50.0 months) showed significant improvement in all patients, with only one experiencing a febrile urinary tract infection.
• Cosmetic results were highly satisfactory, with no obvious visible scars.

Conclusions:

• The hybrid pyeloplasty is a safe and effective minimally invasive surgical option for infant UPJO.
• This technique offers excellent functional and cosmetic outcomes.
• Further studies may be warranted to establish long-term efficacy and compare with other techniques.