OBJECTIVES We present a laparpscopic dismembered pyeloplasty for left ureteropelvic junction (UPJ) stenosis in a 6-year old child. The indication for this operation is an anomalous crossing vessel which closely surrounds the ureter and UPJ and thus does not allow the use of our antegrade transpelvic endopyelotemy technique. MATERIALS AND METHODS The patient is placed in a lumbar position on the right flank. The first 10 mm. trocar is positioned on the superior margin of the umbilicus and the pneumoperitoneum is created. Then the telescope is inserted and, after a careful inspection of the abdominal cavity, 2 10 mm. trocars are placed tranperitoneally on the anterior axillary line. The left renal pelvis, the ureter and the anomalous crossing vessel are identified and the ureter is carefully isolated avoiding damage to the anomalous vessel. Then the ureter is sectioned at the UPJ and a 5F pediatric double-J stent is positioned. We used the Anderson-Hynes technique utilizing the new needle driver Tuason for running sutures (by Cook Urological). Thus the new UPJ is displaced in respect to the anomalous crossing vessel. RESULTS AND CONCLUSIONS The stent is removed after 4 weeks and an intravenous pyelography after 6 months shows a good UPJ patency. We suggest the use of this laparoscopic technique in those particular cases in which it is not possible to perform antegrade transpelvic endopyelotomy with parallel results.
|Number of pages||1|
|Journal||British Journal of Urology|
|Issue number||SUPPL. 2|
|Publication status||Published - 1997|
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