Laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction in children: a single-surgeon experience

The objective of this work is to evaluate the safety and short-term outcomes of laparoscopic dismembered pyeloplasty (LDP) for ureteropelvic junction obstruction (UPJO) in children, based on a single-surgeon experience using a transabdominal suspension technique.

We retrospectively analyzed children with UPJO between January 2023 and October 2024 who underwent transperitoneal LDP with a transabdominal suspension maneuver performed by a single surgeon. The diagnosis was confirmed by ultrasonography and magnetic resonance urography. The outcomes were operative time, complications, hospital stay, and postoperative hydronephrosis reduction, assessed by ultrasonography at least 3 months after the operation.

A total of 60 children with a mean age of 58.5 months (range: 6-168 months) underwent surgery during the study period; of these, 47 were boys. The mean operative time was 140 min (range: 120-200 min). No open conversions or major complications occurred. The mean hospital stay was 3.5 days. The median pelvic diameter decreased from 35.6 mm (range: 25-50 mm) preoperatively to 13.5 mm (range: 8-22 mm) postoperatively (p < 0.05). All patients were free from symptoms with reduced hydronephrosis during the follow-up period.

Transperitoneal laparoscopic dismembered pyeloplasty is a safe and effective option in the treatment of UPJO, and a transabdominal suspension technique may facilitate the procedure.