Laparoscopic and Robotic Pyeloplasty
Laparoscopic pyeloplasty as a treatment option for the obstructed ureteropelvic junction (UPJ) combines the advantage of an open reconstruction under direct magnified vision with the low morbidity of an endoscopic approach. First described as a minimally invasive treatment option by Schuessler and colleagues in 1993 (1), there are several large published series with extended follow-up confirming long-term patency rates of 96–100% (2). These results parallel the outcomes of the prior gold standard approach (i.e., open pyeloplasty) and exceed what is observed with endoscopic incisional operations. 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 to their open surgery counter-parts (3). The recovery as compared to endopyelotomy is less clear. Though technically challenging, the low incidence of failure combined with reduced postoperative morbidity has made this an increasingly popular treatment option at institutions offering this approach.
KeywordsVeress Needle Ureteropelvic Junction Needle Driver Laparoscopic Pyeloplasty Robotic Port
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