Retrograde placement of ureteral stent and ureteropelvic anastomosis with two running sutures in transperitoneal laparoscopic pyeloplasty: Tips of success in our learning curve

Rocco Papalia, Giuseppe Simone, Costantino Leonardo, Salvatore Guaglianone, Ester Forestiere, Maurizio Buscarini, Michele Gallucci

Research output: Contribution to journalArticle

Abstract

Purpose: We report our experience of transperitoneal laparoscopic dismembered pyeloplasties describing our step-by-step surgical technique, and we retrospectively analyze the impact on operative times of technical modifications that were introduced during the learning curve. Patients and Methods: From November 2002 to May 2008, 84 consecutive patients with ureteropelvic junction (UPJ) obstruction were selected for laparoscopic pyeloplasty (LP). The main steps of the surgical procedure are described. In the initial 14 patients who underwent LP, we performed intraoperative antegrade stenting, and we configured the ureteropelvic anastomosis with interrupted sutures; in the 25 following patients, anastomosis was performed with running sutures. In the latest 45 patients, the ureteral stent was positioned retrograde, and ureteropelvic anastomosis was performed with two running sutures. We evaluated the impact of technical modifications on the operative times, dividing patients into three groups (group A, first 14 patients; group B, following 25 patients; and group C, last 45 patients). Median operative times of each group were compared with the Student t test. Results: No major complications ccurred, while postoperative urinary leakage was seen in three patients at bladder catheter removal (two in group A and one in group B). Mean operative blood loss was 70mL, and mean hospital stay was 1.6 days. Median operative time was 115min (range 110-125min) for group A, 100min (range 95-115min) for group B, and 85min (range 65-95min) for group C; differences between operative times of groups A and B and between groups B and C were statistically ignificant (both P

Original languageEnglish
Pages (from-to)847-852
Number of pages6
JournalJournal of Endourology
Volume23
Issue number5
DOIs
Publication statusPublished - May 1 2009

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

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