Laparoscopic pyeloplasty: our new gold standard.

BACKGROUND AND PURPOSE: Laparoscopic pyeloplasty has developed as a successful minimally invasive alternative to open surgery for management of ureteropelvic junction obstruction (UPJO). Reported medium-term success rates match those of open surgery at more than 90%. We present our complete experience to date with the laparoscopic pyeloplasty procedure.

PATIENTS AND METHODS: A retrospective review of all patients who have undergone laparoscopic pyeloplasty at our institution was performed.

RESULTS: Between July 2001 and March 2008, 118 patients underwent laparoscopic pyeloplasty. Mean operative time was 205 minutes, and mean hospital stay was 4.7 days. A crossing vessel was found in 33 patients, and 9 patients needed pyelolithotomy for concomitant stone disease. There were no major complications. Mean followup was 12.38 months (range 3-60 mos) with 94.5% free of obstruction on radiologic imaging.

CONCLUSIONS: Laparoscopic pyeloplasty is a safe and effective management option for UPJO with excellent short-to medium-term results. It is a versatile operation, applicable to most cases of UPJO. Laparoscopic pyeloplasty has now superceded open surgery in our center as the gold standard surgical management for UPJO.