Laparoscopic simultaneous bilateral dismembered pediatric pyeloplasty applying three midline ports.

J Endourol

Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University, M.C. (SBMU), Tehran, Islamic Republic of Iran.

Published: November 2010

Objectives: The objective of this study was to describe our experience with laparoscopic simultaneous bilateral dismembered pyeloplasty in two pediatric cases by using three midline ports.

Methods: A 5-year-old boy and a 5-month-old male infant with bilateral ureteropelvic junction obstruction underwent bilateral laparoscopic transperitoneal dismembered pyeloplasty. A 10-mm trocar was placed through the umbilicus, and two 5-mm trocars were also placed in the midline superior and inferior to the umbilicus. On the left side, dismembered pyeloplasty was performed through a transmesocolic approach. Double-J ureteral stent was inserted through one of the trocars on both sides.

Results: The postoperative period was uneventful. Patients were discharged on postoperative days 4 and 5. Oral feeding was tolerated on the first postoperative day. In a 6-month follow-up period, excretory urography and renal scan showed resolution of obstruction.

Conclusions: Laparoscopic dismembered pyeloplasty can be performed in a single session for pediatric patients with bilateral ureteropelvic junction obstruction. This can obviate the need for two sessions of anesthesia induction and intubation. However, more studies with large number of patients are needed to confirm this result.

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http://dx.doi.org/10.1089/end.2010.0149DOI Listing

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