Abstract
IntroductionThere are only a few reports on laparoscopic pyeloplasty in kidney abnormalities and only one case for laparoscopic pyeloplasty in a duplicated system. Increasing experience in laparoscopic techniques allows proper treatment of such anomalies. However, its feasibility in difficult cases with altered kidney anatomy such as that of duplicated renal pelvis still needs to be addressed.Case presentationWe present a case of a 22-year-old white Caucasian female patient with ureteropelvic junction obstruction of the lower ureter of a completely duplicated system that was managed with laparoscopic pyeloplasty. Crossing vessels were identified and transposed. The procedure was carried out successfully and the patient's symptoms subsided. Follow-up studies demonstrated complete resolution of the obstruction.ConclusionSince laparoscopic pyeloplasty is still an evolving procedure, its feasibility in complex cases of kidney anatomic abnormalities is herein further justified.
Highlights
There are only a few reports on laparoscopic pyeloplasty in kidney abnormalities and only one case for laparoscopic pyeloplasty in a duplicated system
Despite the emergence of endoscopic techniques and the recent development of laparoscopic approaches, many patients with ureteropelvic junction (UPJ) obstruction are still managed through open pyeloplasty
Even though open pyeloplasty remains the standard of treatment for UPJ obstruction management with success rates exceeding 90% [3,4], recent advances in laparoscopic surgery have led an increasing number of surgeons to adopt minimally invasive approaches
Summary
Despite the emergence of endoscopic techniques and the recent development of laparoscopic approaches, many patients with ureteropelvic junction (UPJ) obstruction are still managed through open pyeloplasty. It is probably because of technical difficulties and the need for intracorporeal knot tying that this procedure has not yet been adopted worldwide as the initial treatment of choice in UPJ obstruction. Previous experience with laparoscopic surgery, the patient's young age and the already reported success of the procedure in the upper pole of a duplicated collecting system, pointed toward a laparoscopic rather than an open approach. PtFiroigen-uoorpbeesr1taruticvteiointirnavtehneoluoswpeyreolof gtrhaephtwy;oucroetlleercotpineglvsiycsjtuenmcsPre-operative intravenous pyelography; ureteropelvic junction obstruction in the lower of the two collecting systems
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