Summary

■ Laparoscopic dismembered pyeloplasty was introduced in 1993.

■ Both dismembered and nondismembered pyeloplasties (Foley Y-V, Fenger) may be performed using transperitoneal and retroperitoneal approaches.

■ The transperitoneal approach has been used in most pyeloplasty series.

■ Morbidity of transperitoneal laparoscopic pyeloplasty is considerably less than that of open pyeloplasty. Complications occur in approximately 11% to 20% of patients.

■ Success rates in most recent series of transperitoneal laparoscopic pyeloplasty are above 90% and similar to those obtained with the open approach.

■ Laparoscopic dismembered pyeloplasty is feasible and safe in children.

■ The learning curve of robot-assisted laparoscopic pyeloplasty is steep.

■ The ability of laparoscopic pyeloplasty to directly identify crossing vessels and reduce a large renal pelvis recapitulates the advantages of the open approach.

■ Laparoscopic pyelolithotomy with concomitant pyeloplasty is feasible.

■ Laparoscopic pyeloplasty in the setting of an ectopic or horseshoe kidney has been performed successfully.

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