Postpyeloplasty Procedure

After completion of the anastomosis, a Jackson-Pratt drain is left to bulb suction drainage via a lateral trocar site. Careful inspection of the surgical site is performed at low pressure to ensure good hemostasis. Cautery and hemostatic agents can be utilized to deal with nuisance bleeding. More significant bleeds may require suturing or clip application. In transperitoneal cases, some surgeons will reretroperitonealize the kidney by taking the colon back to the line of Toldt at the end of the case.

After the abdomen is desufflated and the gas expelled, the port sites can be closed under direct vision externally with a 2-0 polyglycolic suture if the patient is fairly thin and the fascia visible. With obese patients, a special port closure device such as the Carter-Thompson needle or CloseSure‚ĄĘc system can be used.

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