Laparoscopic In Situ Dismembered Pyeloplasty as a Modified Technique to Facilitate Suturing and Alignment During Laparosopic Pyeloplasty: A Video Demonstration

Abstract

Abstract Purpose: This video demonstrates the technique of laparoscopic in situ dismembered pyeloplasty as a modified technique during which the alignment of ureter and renal pelvis remains intact during ureteropelvic junction (UPJ) anastomosis. We also showed the intraoperative and postoperative outcomes of this modification in comparison with standard laparoscopic dismembered pyeloplasty. Methods: Patients with significant primary UPJ obstruction without any history of abdominal surgery, high ureter insertion, or renal anomalies were considered. After dissection and mobilization of the UPJ, a 1-cm longitudinal incision was made over the lateral aspect of the proximal ureter distal to the site of obstruction. Another 2-cm oblique incision was made on the lateral aspect of the renal pelvis at its most dependent portion to divide the posterior and anterior walls of the renal pelvis. The most dependent part of the incised renal pelvis was sutured to the distal end of the ureterotomy incision. Then both ante...