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.