Difficulties in Laparoscopic Pyeloplasty

Abstract

Laparoscopic pyeloplasty was first described as a minimally invasive treatment option by Schuessler and colleagues in 1993,¹ and there are now several large published series with extended follow-up confirming long-term patency rates of 96–100%.^2–4 These results parallel the outcomes of the open pyeloplasty. As demonstrated with other minimally invasive operations, patients undergoing laparoscopic pyeloplasty have reduced analgesic requirements, hospital stays, and time until return of full activities compared with their open surgery counterparts. Although technically challenging, the low incidence of failure combined with reduced postoperative morbidity has made this an increasingly popular treatment option at various centers across the globe. This chapter discusses the possible difficulties a surgeon may encounter and also details the possible solutions to these problems.