Insertion of an Internal-External Nephroureteral Stent During Pediatric Laparoscopic Pyeloplasty: Description of the Technique

Abstract

We present a technique for inserting an internal-external nephroureteral antegrade stent during a laparoscopic pyeloplasty. We describe the step-by-step technique for external-internal stent insertion during transperitoneal laparoscopic pyeloplasty: (1) Before completion of the ueretopelvic junction anastomosis, a 14-gauge angiocatheter is inserted and the external-internal stent is advanced under direct vision downward into the ureter. (2) A percutaneous access to the intrarenal collecting system is then performed by using another 14-gauge angiocatheter. (3) Once in the pelvis, a 1.9F stone basket is passed through the angiocath and the proximal arm of the stent is brought out through skin. The key advantage of this internal-external stent is that it can be removed in the clinic, thus not exposing the patient to another general anesthetic or cystoscopy for removal.