Laparoscopic pyeloplasty: our new gold standard.

BACKGROUND AND PURPOSE

Laparoscopic pyeloplasty has developed as a successful minimally invasive alternative to open surgery for management of ureteropelvic junction obstruction (UPJO). Reported medium-term success rates match those of open surgery at more than 90%. We present our complete experience to date with the laparoscopic pyeloplasty procedure.

PATIENTS AND METHODS

A retrospective review of all patients who have undergone laparoscopic pyeloplasty at our institution was performed.

RESULTS

Between July 2001 and March 2008, 118 patients underwent laparoscopic pyeloplasty. Mean operative time was 205 minutes, and mean hospital stay was 4.7 days. A crossing vessel was found in 33 patients, and 9 patients needed pyelolithotomy for concomitant stone disease. There were no major complications. Mean followup was 12.38 months (range 3-60 mos) with 94.5% free of obstruction on radiologic imaging.

CONCLUSIONS

Laparoscopic pyeloplasty is a safe and effective management option for UPJO with excellent short-to medium-term results. It is a versatile operation, applicable to most cases of UPJO. Laparoscopic pyeloplasty has now superceded open surgery in our center as the gold standard surgical management for UPJO.