V576: RETROPERITONEOSCOPIC MINIPORT PYELOPLASTY IN CHILDREN: A SINGLE-CENTER EXPERIENCE
VideoIntroduction and Objectives
Laparoscopic pyeloplasty (LPP) for treatment of ureteropelvic junction obstruction (UPJO) is comparable to open pyeloplasty regarding success rates. Experience with miniport LPP however remains limited. We aim to present our outcomes for retroperitoneoscopic miniport LPP for UPJO.
Between April 2011 and October 2012 a total of 16 patients were operated for UPJO using the miniport LPP technique. After the retrograde pyelography, retroperitoneal access was achieved under the vision of a 5mm 30° telescope at the 90° flank position, with the aid of balloon dilatation. One 5mm trocar for telescope and a pair of 3.5mm trocars were applied. The proximal ureter was dissected with bluntly, and the ureter was spatulated without being separated from the kidney pelvis. Pyeloplasty was performed by Anderson-Hynes technique using 5/0 vicryl. After pyeloplasty, a JJ stent was placed and the drain was left in situ in the retroperitoneal space.
Ten boys and six girls with an average age of 8.57±5.62 (1-17) years were evaluated. 11 cases were on the left and 5 were on the right side. Mean operation time was 123.4±32.1 (80-190) minutes, blood loss was minimal and hospital stay was 2.93±1.9(2-9) days. One minor complication (Clavien classification) was present.
By the end of 3 months, no obstruction was observed in 15 cases scintigraphically. In the remaining one case while there were improvement both clinically and ultrasonographically however no change was observed on MAG-3 scintigraphy.
Retroperitoneoscopic miniport pyeloplasty is a feasable technique to be preferred in terms of functional and cosmetic aspect.