Retroperitoneal versus transperitoneal laparoscopic pyeloplasty: our experience

Urol Int. 2010;85(3):309-13. doi: 10.1159/000319395. Epub 2010 Jul 20.

Abstract

Objective: Laparoscopic pyeloplasty, which has been quoted to have a success rate equivalent to open pyeloplasty for ureteropelvic junction obstruction (UPJO), can be performed transperitoneally and retroperitoneally. The aim of the present study is to report our experience with these 2 routes of laparoscopic pyeloplasty and to further improve our understanding of the merits and demerits of these 2 routes.

Patients and methods: A total of 47 laparoscopic pyeloplasties were performed at our center from June 2000 to August 2009. Twelve pyeloplasties were performed transperitoneally and 35 retroperitoneally.

Results: In the retroperitoneal group, we had a success rate of 91.5% after a mean follow-up of 22 months, and in the transperitoneal group, we had a success rate of 91.7% after a mean follow-up of 48 months. The mean operative time was 156 min in the retroperitoneal group and 195 min in the transperitoneal group.

Conclusion: This study shows a success rate comparable with open pyeloplasty and favors the retroperitoneal route with a shorter operative time, less dissection needed, a higher sensitivity of detecting crossing vessels, a decreased risk in visceral injury and an early start of oral feeds.

MeSH terms

  • Adult
  • Anastomosis, Surgical
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Nephrology / methods
  • Postoperative Complications
  • Retroperitoneal Space / surgery*
  • Stents
  • Surgical Procedures, Operative / methods*
  • Ureteral Obstruction / diagnosis
  • Ureteral Obstruction / surgery*
  • Urology / methods*