Retroperitoneal laparoscopic dismembered pyeloplasty: experience with 50 cases.

OBJECTIVES

To report our techniques and experience with retroperitoneal laparoscopic dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction.

METHODS

From May 2000 to September 2004, 50 patients with UPJ obstruction underwent laparoscopic dismembered pyeloplasty. A three-port, balloon-dissecting, retroperitoneal approach was used. All anastomoses were completed with free-hand intracorporeal suture techniques. Follow-up studies were performed with intravenous urography and renal ultrasonography.

RESULTS

All operations were completed laparoscopically, and no open conversions were required. The mean operating time was 81.6 minutes (range 55 to 180). The mean blood loss was 12 mL (range 5 to 50), and the mean postoperative hospitalization stay was 7.6 days (range 6 to 12). No intraoperative complications occurred. Aberrant artery vessel and primary stricture as the cause of UPJ obstruction was noted in 6 and 44 patients, respectively. Anastomotic leakage occurred in 2 patients, 1 of whom later underwent open surgery for recurrent UPJ obstruction. Radiographic assessment by intravenous urography showed good results in 49 patients at a mean follow-up of 22 months.

CONCLUSIONS

Our experience with retroperitoneal laparoscopic dismembered pyeloplasty has demonstrated that this technique is an effective treatment for UPJ obstruction and can be accomplished reasonably quickly.