One-Port Retroperitoneoscopic Assisted Pyeloplasty

Abstract

Purpose Laparoscopic pyeloplasty remains a challenging procedure in children. One-Port-Retroperitoneoscopic-Assisted-Pyeloplasty (OPRAP) is proposed as minimally invasive approach with the advantages of open and laparoscopic procedures. Aim: to verify safety and effectiveness of OPRAP, compared to open dismembered pyeloplasty (ODP). Material and Methods From January 2008 to June 2009, children aged 6 months-5 years with ureteropelvic junction (UPJ) obstruction were offered OPRAP. As control group, age-matched patients who underwent ODP during 2007 year were enrolled. The UPJ was isolated retroperitoneoscopically, through a single operative trocar, and exteriorized. Pyeloplasty was performed in an open fashion, with double-J stenting. Operative time, surgical complications, hospital stay, Ultrasound and nuclear scan results at 6-month follow-up were compared. Post-operative pain was evaluated by FLACC scale. The Chi-square and Student t-test were adopted for statistical analysis, considering p Results 28 children, mean age 18 months, were treated by OPRAP (17 males, 18 left sided). As control group, 25 patients, mean age 19 months (11 males, 10 left kidney). Mean operative time was 95 mins (70-130 mins) in OPRAP and 72 mins (58-102 mins) in ODP (p Conclusions OPRAP represents a safe and effective minimally invasive technique to treat hydronephrosis and could be the treatment of choice in young children. It does not require the laparoscopic suturing skills, and summarizes the advantages of open and laparoscopic pyeloplasty.