Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco.
Urology. 2012 Jan;79(1):227-30. doi: 10.1016/j.urology.2011.07.1437. Epub 2011 Nov 4.
Percutaneous endopyeloplasty is a horizontal suturing of the endopyelotomy incision via a unique percutaneous tract. We present a feasibility study of our technique of percutaneous endopyeloplasty using a conventional suture with a laparoscopic needle holder via the nephroscope.
A longitudinal endopyelotomy incision is performed through a 24-Fr working sheath placed via an upper calyx. Then an initial suture is placed, approximating the endopyelotomy incision distal and proximal apex, using a conventional absorbable 13-mm needle suture with a lengthened 3.5-mm pediatric laparoscopic needle holder, via the nephroscope. If possible, an additional 2 sutures are eventually placed, 1 on either side of the initial midline suture.
Percutaneous endopyeloplasty, using a conventional suture with a pediatric laparoscopic needle holder via a nephroscope, is technically possible, reproducible, and effective, and was performed in 10 consecutive patients. The tissue approximation provides a fast, full thickness ureteral healing. Endopyelotomy horizontal suturing leads to a wider caliber reconstruction of the ureteropelvic junction.
Percutaneous endopyeloplasty is a promising technique. Our procedure for endopyeloplasty is technically feasible and effective, with little need for highly specialized equipment. However, further technical experience and longer follow-up in a larger group of patients are necessary for more development of this technique.
经皮肾镜肾盂成形术是通过独特的经皮途径对肾盂切开处进行水平缝合。我们介绍了一种经皮肾盂成形术的可行性研究，该技术使用常规缝线和腹腔镜持针器经肾镜进行操作。
通过放置在上盏的 24Fr 工作鞘进行纵向肾盂切开术。然后使用常规可吸收 13mm 缝线和延长的 3.5mm 儿科腹腔镜持针器，通过肾镜在肾盂切开术的远侧和近侧尖端附近放置初始缝线，以近似肾盂切开术的切口。如果可能，最终在初始中线缝线的任一侧放置另外 2 个缝线。
经皮肾盂成形术，使用常规缝线和儿科腹腔镜持针器经肾镜进行操作，在技术上是可行的、可重复的且有效的，并在 10 例连续患者中进行了操作。组织接近提供了快速、全层输尿管愈合。肾盂切开术的水平缝合导致输尿管肾盂连接部更宽的口径重建。
经皮肾盂成形术是一种有前途的技术。我们的经皮肾盂成形术程序在技术上是可行且有效的，几乎不需要高度专业化的设备。然而，需要更多的技术经验和更长时间的随访，以进一步发展这项技术。
