Laparoscopic Transperitoneal Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction

PURPOSE: To review the outcome of transperitoneal laparoscopic dismembered pyeloplasty (LDP) in our institution. PATIENTS AND METHODS: From April 2001 to April 2005, 36 men and 34 women underwent LDP for symptomatic and radiologically proved ureteropelvic junction (UPJ) obstruction. A successful outcome was defined clinically by improvement in symptoms and objectively by improvement in the diuretic renography study performed at 3 and 12 months after reconstruction. RESULTS: The mean operative time was 160.5 +/- 45 minutes with a mean blood loss of 77.8 +/- 52.8 mL. There were no conversions to open surgery. Lower-pole vessels were observed in 38 patients (54.3%). In all cases, the ureter was transposed anteriorly. The mean hospital stay was 3.3 +/- 2.1 days. Postoperative complications were recorded in 4 patients (5.7%). One patient developed an anastomotic stricture. A successful outcome was achieved in 68 of the 70 patients (97.1%) at a mean follow-up of 27.6 +/- 13.2 months. CONCLUSION: Our results further strengthen the evidence that LDP has a reliable medium-term outcome with the added benefit of being minimally invasive.