Pyeloplasty Technique

Intracorporeal suturing is a necessary part of laparoscopic pyeloplasty. A 4-0 polygly-colic suture is used. Interrupted or running technique can be used. Freehand technique or mechanically assisted suturing can be used. An automatic laparoscopic suturing instrument such as the Endostitch (Fig. 2) can be used.

The author's preference is the interrupted technique for the following reasons:

1. Interrupted suture is potentially less ischemia producing.

2. Correction of unevenness in the anastomosis is easier.

3. A running anastomosis can be compromised by an air knot, and could require redoing the entire anastomosis.

Surgical Tip

Clipping stay sutures to cut edges of the peritoneum can facilitate suturing the anastomosis. This frees up both of the surgeon's hands for suture placement and obviates the need for an assistant to assist with the anastomosis.

Anderson-Hynes dismembered pyelo-plasty is preferred when pelvic reduction may be necessary, a renal calculus is present, or a crossing vessel is encountered.

Baby Sleeping

Baby Sleeping

Everything You Need To Know About Baby Sleeping. Your baby is going to be sleeping a lot. During the first few months, your baby will sleep for most of theday. You may not get any real interaction, or reactions other than sleep and crying.

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