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Open pyeloplasty

Thomas A A Skinner, Luke Witherspoon, Ali Dergham, Jeffery E Warren, James Watterson, Brian Blew
INTRODUCTION: Ureteropelvic junction obstruction (UPJO) is a condition characterized by partial or complete obstruction of urine transport from the renal pelvis to the ureter and can present with intermittent flank pain, recurrent urinary tract infections, renal stones, or renal dysfunction. While historically, open pyeloplasty was the gold standard for surgical management, laparoscopic methods to repair UPJO have largely taken over as the preferred approach for adolescent and adult patients...
January 21, 2019: Canadian Urological Association Journal
Mohammad Hadi Radfar, Amir Afyouni, Behnam Shakiba, Sepehr Hamedanchi, Ali Zare
BACKGROUND: The most difficult, time-consuming, and critical steps of laparoscopic pyeloplasty (LPP) are ureteral spatulation, apical ureteral stitch placement, and ureteropelvic anastomosis. To simplify these critical steps, avoid the risk of ureteral shortening, and also minimize ureteral manipulation, we present a modified dismembered technique for suturing with the outcome of patients who underwent LPP using this technique. MATERIALS AND METHODS: This study included 23 patients who were candidates for transperitoneal dismembered Anderson-Hynes LPP...
February 6, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Jihad Kaouk, Riccardo Bertolo
The initial experience with urological robotic interventions performed by using the Da Vinci SP® robotic surgical platform (Intuitive Surgical, Sunnyvale, CA, USA) during the first month (September 28th - October 30th, 2018) after the system was installed at our institution is reported herein. The aim of the study was to determine the feasibility and the safety of major urologic procedures as measured by the rate of conversions and the incidence of perioperative complications. Secondary aims of the study consisted of key perioperative surgical outcomes including operative time, blood loss, and length of stay...
January 28, 2019: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Ciro Esposito, Lorenzo Masieri, Thomas Blanc, Gianantonio Manzoni, Selcuk Silay, Maria Escolino
PURPOSE: This multicentric study aimed to report our experience with robot-assisted laparoscopic pyeloplasty (RALP) in children with horseshoe kidney (HSK). METHODS: The records of 14 patients (11 boys and 3 girls with an average age of 9 years), who underwent RALP for repair of pelvi-ureteric junction obstruction (PUJO) in HSK in five international pediatric urology units over a 5-year period, were retrospectively reviewed. A dismembered pyeloplasty with no division of isthmus was performed in all the cases...
January 14, 2019: World Journal of Urology
Ilan Z Kafka, Stanislav Kocherov, Jawdat Jaber, Boris Chertin
PURPOSE: RALP is rapidly becoming the new gold standard treatment for UPJO in children, who suffer from uretero-pelvic obstruction (UPJO). However, presently there is a lack of data regarding the outcomes of RALP in young infants and smaller children. This study aims to compare the outcomes of RALP in children weighing less than 10 kg and matched with an analogous cohort who underwent open pyeloplasty (OP). METHODS: We prospectively compared patients who underwent RALP to a matched cohort of patients who underwent OP from our retrospectively acquired data registry...
January 14, 2019: Pediatric Surgery International
Peng Hong, Ziao Li, Dongdong Zhu, Liyan Zhuang, Kunlin Yang, Han Hao, Xuesong Li, Liqun Zhou
OBJECTIVE: To present our technique of laparoscopic pyeloplasty (LP) with concomitant pyelolithotomy in ureteropelvic junction obstruction (UPJO) complicated by renal calculi and compare outcome with a group of UPJO patients undergoing modified LP without coexistent calculi. MATERIALS AND METHODS: We retrospectively reviewed the charts of 51 UPJO patients undergoing modified LP from January 2013 to November 2016 at our institution. Sixteen patients were diagnosed as UPJO with coexistent ipsilateral renal calculi and underwent pyelolithotomy using our modified technique at the time of modified LP...
January 10, 2019: Urologia Internationalis
M İrfan Dönmez, Alonso Carrasco, Amanda F Saltzman, Duncan T Wilcox
OBJECTIVE: In the majority of published series, children undergoing open pyeloplasty are admitted for at least one night. We hypothesized that it would be possible in the majority of infants to perform open pyeloplasty as an outpatient procedure. MATERIALS AND METHODS: All patients who underwent open pyeloplasty by a single surgeon between 2008 and 2016 were retrospectively reviewed. Demographic data (age at surgery, gender, pre- and postoperative imaging studies, laterality, type of local anesthesia), operative time, duration of hospital stay, need for narcotic analgesics, complications, readmission within 1-month after surgery and need for additional procedures were abstracted...
December 5, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Riccardo Lombardo, Raul Martos, Maria J Ribal, Antonio Alcaraz, Andrea Tubaro, Cosimo De Nunzio
BACKGROUND: In the past years, several authors have focused on the role of retroperitoneoscopic laparoscopy in the treatment of urological diseases. Aim of our study is to systematically review the available literature on retro-peritonescopic laparoscopy in urology. EVIDENCE ACQUISITION: A systematic review of the literature using the Medline, Scopus and Web of Science databases for relevant articles published until June 2018 was performed using both the Medical Subjects Heading and free test protocols...
January 2, 2019: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Nilesh G Nagdeve, Pravin D Bhingare, Prashant Sarawade
Aim: The aim of the study was to compare the efficacy and postoperative complications of stented and nonstented open pediatric dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction. Settings and Design: A balanced, parallel group, prospective randomized controlled trial comparing stented and nonstented Anderson-Hynes Dismembered Pyeloplasty. Subjects and Methods: It included 42 children who required Anderson-Hynes dismembered pyeloplasty for UPJ obstruction (UPJO)...
October 2018: Journal of Indian Association of Pediatric Surgeons
Mohamed Gadelmoula, Mohammad S Abdel-Kader, Mahmoud Shalaby, Mostafa Abdelrazek, Ahmed Mohamed Moeen, Mohamed Ali Zarzour, Nasreldin Mohammed, Paolo Fornara
Introduction: To prospectively compare the perioperative and functional outcomes of laparoscopic (LP) and open pyeloplasty (OP) in three academic institutions. Material and methods: Between September 2012 and September 2016, 102 patients with primary uteropelvic junction obstruction (UPJO) underwent pyeloplasty (51 LP and OP for the other 51 patients). Demographic data, perioperative parameters, including operative time, estimated blood loss, complications, length of hospital stay, and functional outcome were compared, and SF-8 Health Survey scoring was recorded for each group...
2018: Central European Journal of Urology
Hamdan Hammad Alhazmi
Laparoscopic pyeloplasty (LP) is more beneficial than open procedures. However, studies on laparoscopic management of cases with secondary ureteropelvic junction obstruction (SUPJO) after previous failed pyeloplasty in the pediatric population are lacking. This meta-analysis aimed to assess the difference between redo LP (RLP) and redo open pyeloplasty (ROP) for children with SUPJO, focusing on certain criteria. All recent studies on RLP and ROP in children with SUPJO were searched. Search engines such as Medline, PubMed, and The Cochrane Library of Systematic Reviews were used...
October 2018: Urology Annals
Kentaro Mizuno, Yoshiyuki Kojima, Hidenori Nishio, Seiji Hoshi, Yuichi Sato, Yutaro Hayashi
Robot-assisted laparoscopic surgery (RALS) has been increasingly embraced in the fields of adult and pediatric urology, especially in North America and Europe. The advantages of a stable magnified 3-D view, tremor filtering, and motion scaling allow for precise intracorporeal exposure and suturing. Because most surgeries are performed as reconstructive rather than excision procedures, the robotic platform is particularly feasible for the field of pediatric urology. In this review, we summarize the recent viewpoints on RALS, such as pyeloplasty, ureteral reimplantation, bladder neck reconstruction, bladder neck sling, appendicovesicostomy, bladder diverticulectomy, and treatments for ureterocele or ectopic ureters, and we also critically summarize the current status of the literature...
November 2018: Asian Journal of Endoscopic Surgery
İbrahim Erol, Kaan Karamık, Mahmut Ekrem İslamoğlu, Mutlu Ateş, Murat Savaş
PURPOSE: The aim of this study was to evaluate the outcomes of laparoscopic pyeloplasty in children less than 12 months of age. MATERIALS AND METHODS: The records of 20 infants, who had pelviureteric junction obstruction and subsequently underwent LP from January 2013 to November 2016 with at least 1 year of follow-up, were retrospectively reviewed. Patients demographics, the results of preoperative and postoperative imaging studies, perioperative details, complications, and results were noted...
September 25, 2018: Urologia
Peng Hong, Guangpu Ding, Dongdong Zhu, Kunlin Yang, Jinhong Pan, Xuesong Li, Zhipeng Chen, Lei Zhang, Qi Tang, Han Hao, Zhansong Zhou, Liqun Zhou
OBJECTIVE: To compare the outcomes of modified laparoscopic pyeloplasty (LP) and robot-assisted pyeloplasty (RLP) for ureteropelvic junction obstruction (UPJO) in China patients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent modified LP and RLP using a transperitoneal laparoscopic approach at 2 different medical institutions between October 2009 and November 2017. RESULTS: Seventy-six patients underwent modified LP and 140 patients underwent RLP...
2018: Urologia Internationalis
Santosh Kumar, Abhishek Chandna, Dharmendar Aggarwal, Shantanu Tyagi, Nripesh Sadasukhi
Uretero-pelvic junction obstruction (UPJO) is a common condition, often presenting in adulthood in developing countries. These cases can pose significant problems owing to late presentation and complications such as infection, stones, and impaired renal function. We present the case of a 28-year-old female who presented to us with recurrent symptoms and impaired drainage following a failed open pyeloplasty and robot-assisted ureterocalycostomy for right UPJO. She was managed by robot-assisted boari flap calycovesicostomy, an innovation which helped in salvaging her kidney; ensuring good drainage in the involved kidney...
August 22, 2018: Journal of Robotic Surgery
G Goetz, M Klora, J Zeidler, S Eberhard, S Bassler, S Mayer, J-H Gosemann, M Lacher
INTRODUCTION:  Surgery for ureteropelvic junction obstruction (UPJO) is performed by both pediatric surgeons (PS) and urologists (URO). The aim of this study was to analyze treatment modalities for UPJO and results in relation to the surgical technique and the operating discipline in Germany. MATERIAL AND METHODS:  Data of patients aged 0 to 18 years were extracted from a major public health insurance (covering ∼5.7 million clients) during 2009 to 2016 and were analyzed for sociodemographic variables, surgical technique, and treating discipline...
August 15, 2018: European Journal of Pediatric Surgery
Minki Baek, Mesrur Selcuk Silay, Jason K Au, Gene O Huang, Rodolfo A Elizondo, Kathleen T Puttmann, Nicolette K Janzen, Abhishek Seth, David R Roth, Chester J Koh
INTRODUCTION: Pediatric robot-assisted laparoscopic (RAL) pyeloplasty has become a viable minimally invasive surgical option for ureteropelvic junction obstruction (UPJO) based on its efficacy and safety. However, RAL pyeloplasty in infants can be a challenging procedure because of the smaller working spaces. The use of the larger 8 mm instruments for these patients instead of the 5 mm instruments is common because of the shorter wrist lengths. OBJECTIVE: We hypothesized that the use of 5 mm instruments for RAL pyeloplasty in infants with smaller working spaces will have comparable perioperative parameters and surgical outcomes in comparison with older children with larger working spaces...
July 6, 2018: Journal of Pediatric Urology
Jens Rassweiler, Jan Klein, Ali Serdar Goezen
Objective: To compare laparoscopic Anderson-Hynes pyeloplasty (LAHP) and retroperitoneal laparoscopic YV-pyeloplasty (LRYVP) in ureteropelvic junction obstruction (UPJ) in presence of a crossing vessels (CV). Methods: Our database showed 380 UPJO-cases,who underwent laparoscopic retroperitoneal surgery during the last 2 decades including 206 non-dismembered LRYVP, 157 dismembered pyeloplasties LAHP, and 17 cases of laparoscopic ureterolysis. Among them 198 cases were suitable for a matched-pair (2:1) analysis comparing laparoscopic retroperitoneal non-dismembered LRYVP (Group 1, n  = 131) and dismembered LAHP (Group 2, n  = 67) in presence of a crossing vessel...
July 2018: Asian Journal of Urology
Abdrabuh M Abdrabuh, Elsayed M Salih, Mahmoud Aboelnasr, Hussein Galal, Abdelbasset El-Emam, Tarek El-Zayat
PURPOSE: We compared endopyelotomy to redo pyeloplasty for the treatment of failed pyeloplasty in children to identify factors that may have an impact on outcome and favor one procedure over the other. METHODS: Of 43 patients with recurrent UPJO, EP was performed in 27 and RP was performed in 16. Age, gender, side, presentation of secondary UPJO, hospital stay, complications and success rates were compared. Success was defined as radiographic relief of obstruction as determined by ultrasound or diuretic renography at latest follow-up...
November 2018: Journal of Pediatric Surgery
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