Section of Urology, Department of Surgery, University of Arizona, Tucson, Arizona, USA.
Published: March 2002
AI Article Synopsis
Article Abstract
Purpose: We present our experience with laparoscopic pyeloplasty plus pyelolithotomy in patients in whom stones were not the cause of ureteropelvic junction obstruction.
Materials And Methods: A transperitoneal approach was used for laparoscopic pyeloplasty and pyelolithotomy in 19 patients (20 renal units). Before ureteropelvic junction repair stones were extracted through a small pyelotomy that was eventually incorporated into the final pyeloplasty incision. Stones in the renal pelvis were removed with rigid graspers under direct laparoscopic vision. A flexible cystoscope introduced through a port was used to extract stones in the calices. The renal pelvis was reconstructed based on the anatomy of the ureteropelvic junction.
Results: A median of 1 stone (range 1 to 28) was recovered. In 11, 8 and 1 patients the Anderson-Hynes dismembered pyeloplasty, Y-V plasty and the Heinecke Mickulicz procedure were performed, respectively. At 3 months 2 patients had residual calculi for a procedural stone-free rate of 90%. There was no evidence of obstruction in 18 of the 20 cases (90%), as confirmed by negative diuretic scan or radiological improvement of hydronephrosis. At a mean followup of 12 months (range 3 to 57) 2 additional patients had recurrent stones for an overall long-term stone-free rate of 80% (16 of 20).
Conclusions: Laparoscopic pyelolithotomy is feasible when combined with pyeloplasty. Our results are comparable to those of stone removal during open pyeloplasty or percutaneous endopyelotomy. The advantages of open surgery appear to be maintained in this minimally invasive approach.
A case of redo pyeloplasty using robot-assisted retroperitoneoscopic pyeloplasty (RARP) for failed primary laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) is reported. A 12-year-old boy had LP elsewhere. He was referred for management of persistent left hydronephrosis, but was managed conservatively due to minimal symptoms and stable radioisotopic renography.
Objectives: Previous studies on Enhanced Recovery After Surgery (ERAS) in pediatric Laparoscopic Pyeloplasty (LP) lacked clear control cases and discussed the obstacles in the implementation process. This article details the obstacles and lessons learned during the implementation of ERAS in patients with ureteropelvic junction obstruction (UPJO).
Methods: An ERAS protocol was implemented in the UPJO population undergoing LP, which included preoperative, intraoperative, and postoperative management.
The current study aimed to investigate the feasibility and safety of robot-assisted laparoscopic resection of the isthmus in patients with symptomatic horseshoe kidney. A retrospective analysis of clinical data from four patients with symptomatic horseshoe kidney treated between January 1, 2021 and December 31, 2023 at Guizhou Provincial People's Hospital was conducted. The main surgical procedures included robot-assisted laparoscopic resection of the isthmus, kidney fixation, pyeloplasty, and pyelolithotomy.
Introduction: We describe a method of robotic ureterocalicostomy (RALUC) with the Da Vinci Single Port (SP) platform and present clinical outcomes in our cohort of patients.
Materials And Methods: We retrospectively reviewed all patients undergoing RALUC with the SP platform in a single-institution, IRB-approved database between 2020-2023. Demographics, preoperative, intraoperative, and postoperative outcomes were collated.
A 16-year-old male presented to OPD with right-sided flank pain associated with lower urinary tract symptoms. CT scan and ultrasound findings demonstrated a 12.9 mm renal stone in the lower calyx and moderate hydronephrosis, respectively.
