V2157: Transperitoneal Laparoscopic Pyeloplasty After Failed Open PUJO Repair, In better and worse!

Video

Introduction and Objectives
To report our experience in treating patients with failed previous open pyeloplasty by transperitoneal laparoscopic pyeloplasty.

Methods
15 patients with previous failed open pyeloplasty were reviewed, all of them were submitted to transperitoneal laparoscopic pyeloplasty. All procedures were performed by the same surgeon [AH]. Dismembered pyeloplasty technique was utilized in all cases. Follow-up was carried out by ultrasonography initially, and diuretic renal scintigraphy and/or intravenous urography at least 6 months after the removal of the stent.

Results
: The study group consisted of 7 men and 8 women with the mean age of 30.4 years (range, 22 to 45 years). Mean operative time was 135 minutes (range, 110 to 180 minutes) and mean hospital stay was 4.6 days (range, from 3 to 10 days). Mean follow-up was 10.1 months (range, 6 to 18 months). The overall success rate was 80% (8 cases). Post operative Pain after DJ removal was experienced in 3 cases, two cases required reinsertion of DJ stent for a month then removed without further signs of definite obstruction. The other case required PCN (infected hydronephrosis), for which, renal scan was done revealing split function of that kidney less than 10%, and the patient was submitted to nephrectomy later on. There was no conversion to open surgery with no major complications or required blood transfusion.

Conclusions
Laparoscopic pyeloplasty can be a promising method in treating patients with failed open pyeloplasty and it can be considered as a successful minimally invasive method instead of the open techniques for the redo cases.

Funding: none