Laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction

The treatment of ureteropelvic junction (UPJ) obstruction has evolved over the past several years with the implementation of endopyelotomy techniques and, more recently, hot wire balloon incision of the stenotic UPJ. Nonetheless, the long-term results suggest, at least for primary treatment, that none of the new techniques provide the long-term outcomes achieved with traditional open pyeloplasty techniques. I describe the technique of laparoscopic dismembered pyeloplasty, a possible bridge between the open and endoscopic approaches. Difficulties associated with laparoscopic reconstructive procedures are discussed as well as innovative developments that may overcome these problems and truly allow laparoscopic procedures to assume a more prominent role in urologic surgery.