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Urinary Tract Calculi VI: Surgical Management

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Updated: Apr 25, 2026

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

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Laparoscopic pyeloplasty

L R Kavoussi¹, C A Peters

¹Harvard Program in Urology (Longwood Area), Boston, Massachusetts.

The Journal of Urology

|December 1, 1993

Summary

This summary is machine-generated.

A young woman experienced ureteropelvic junction obstruction caused by abnormal blood vessels. Laparoscopic surgery successfully resolved the blockage, restoring normal urine flow.

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Area of Science:

Urology
Minimally Invasive Surgery
Pediatric Surgery

Background:

Ureteropelvic junction (UPJ) obstruction is a common cause of pediatric kidney issues.
Anomalous lower pole renal vessels are a frequent cause of UPJ obstruction.
Surgical intervention is often necessary to relieve the obstruction and preserve renal function.

Observation:

A 24-year-old female presented with symptoms of right UPJ obstruction.
The obstruction was attributed to aberrant lower pole renal vasculature compressing the ureteropelvic junction.
Conservative management was not indicated due to symptomatic presentation.

Findings:

A dismembered pyeloplasty was performed to correct the UPJ obstruction.
The procedure was executed entirely laparoscopically, minimizing invasiveness.
Successful relief of the obstruction was achieved, confirmed by imaging and symptom resolution.

Implications:

Laparoscopic pyeloplasty is a safe and effective treatment for UPJ obstruction caused by crossing vessels.
Minimally invasive approaches offer benefits such as reduced pain and faster recovery.
Early diagnosis and surgical correction are crucial for preventing long-term renal damage.