Practical refinaments in simplified laparoscopic pyeloplasty

OBJECTIVES: Laparoscopic pyeloplasty (LP) is the treatment of choice for ureteropelvic junction obstruction (UPJO). We present the 3-trocars LP technique with several considerations and practical advices. METHODS: Several maneuvers to optimize exposure and simplifying the implementation of the operation were showed. A total of thirteen patients with UPJO and criteria for surgical treatment were included, and were operated using the 3 trocars LP technique. Demographic data, perioperative and follow-up were collected retrospectively. RESULTS: Mean operative time was 132 minutes. No conversion to open surgery was registered and additional trocar insertion was not required. Neither perioperative complications nor postoperative complications were reported. Three patients needed ureteral stenting preoperatively for pain. Five patients required flexible nephroscopy with CO2 for extraction of calyceal stones. The pain was controlled in all cases. CONCLUSIONS: The LP is a feasible and safe technique for the surgical correction of UPJO, and maneuvers presented in this study simplify the procedure and may be applied in other laparoscopic procedures.