Efficacies of ureter externalization and stenting during laparoscopic Anderson-Hynes pyeloplasty

Abstract

Objective To evaluate the efficacies of urethral externalization and stenting during laparoscopic Anderson-Hynes pyeloplasty. Methods From July 2015 to March 2016, 38 cases of urethral externalization and stenting were performed during laparoscopic pyeloplasty. There were 25 boys and 13 girls. Left (n=26) and right (n=12) pyeloplasty were performed. Ureteropelvic junction (UPJ) and proximal ureter were dissected. After urethral spatulation, abdomen was desufflated, Trocar removed and proximal ureter liberated to skin level. Bladder stent was inserted in an antegrade fashion. The first stitch was applied to lower ureter with 5-0 vicryl and then abdomen insufflated again. Proximal ureter was returned into abdomen. Laparoscopic urethral anastomosis was performed routinely. Results All operations were successful and all stents correctly placed. The mean operative duration was 106 (78-230) min, mean duration of urethral stenting 5 (3-8) min and mean length of hospitalization 5-7 days. None of them had a conversion into open surgery. And there was no onset of postoperative complications related with urethral externalization and stenting. All stents were removed cystscopically within 4-6 weeks. Conclusions Ureter externalization and stenting is both convenient and reliable during laparoscopic pyeloplasty. And this technique facilitates the insertion of urethral stent and obviates the problems of body repositioning. Key words: Laparoscopic pyeloplasty; Hydronephrosis; Ureteropelvic junction obstruction; Stents