Laparoscopic Pyeloplasty Current Status

Ioannis M. Varkarakis and Thomas W. Jarrett

The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.

■ INTRODUCTION

■ CURRENT MANAGEMENT OF URETEROPELVIC JUNCTION OBSTRUCTION AND INDICATIONS FOR LAPAROSCOPIC PYELOPLASTY

■ RESULTS: TRANSPERITONEAL LAPAROSCOPIC PYELOPLASTY

■ RESULTS: RETROPERITONEAL LAPAROSCOPIC PYELOPLASTY

■ LAPAROSCOPIC PYELOPLASTY IN CHILDREN

■ ROBOT-ASSISTED LAPAROSCOPIC PYELOPLASTY

■ LAPAROSCOPIC PYELOPLASTY FOR SECONDARY URETEROPELVIC JUNCTION OBSTRUCTION

■ LAPAROSCOPIC PYELOPLASTY WITH CONCOMITANT PYELOLITHOTOMY

■ LAPAROSCOPIC PYELOPLASTY IN THE PRESENCE OF UPPER URINARY TRACT ABNORMALITIES

■ MANAGEMENT OF FAILED PRIMARY LAPAROSCOPIC PYELOPLASTY

■ REFERENCES

■ COMMENTARY: Michael C. Ost and Arthur Smith

The gold standard therapy for repair of ureteropelvic junction obstruction has been open pyeloplasty. Long-term success rates consistently exceed 90%.

In an effort to achieve both minimal morbidity and results equivalent to or better than those of open surgery, laparoscopic dismembered pyeloplasty was introduced in 1993.

Dismembered and nondismembered pyeloplasties may be performed using transperitoneal and retroperitoneal laparoscopic approaches.

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