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Year : 2015  |  Volume : 12  |  Issue : 4  |  Page : 266-269

One-trocar-assisted pyeloplasty: An attractive alternative to open pyeloplasty

Department of Paediatrics and Paediatric Surgery, Second University of Naples, Caserta, Italy

Correspondence Address:
Prof. Alfonso Papparella
Second University of Naples, Largo Madonna Delle Grazie 1, 80100 Napoli
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0189-6725.172569

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Background: To survey the effects of one-trocar-assisted pyeloplasty (OTAP) in the treatment of ureteropelvic junction obstruction (UPJO) in kids. Materials and Methods: Forty-four children (±3.5 years) were submitted to OTAP procedure. A flank incision under the XII rib was made, the Gerota's fascia was achieved and a balloon Hasson trocar with an operative telescope inserted for retroperitoneal access. The renal pelvis and ureter were isolated and exteriorised. Forty-two patients underwent Anderson-Hynes dismembered and one Fenger pyeloplasty . One patient was converted to an open procedure. Two patients presented an aberrant crossing vessel. In all patients, a double J stent was positioned. The operative time and length of stay (LOS) were evaluated. Renal scan and ultrasound (US) were utilised to evaluate the results from 6 to 12 months. Results: OTAP was successful in all but 1 patient. Mean operative time and LOS were 128 min and 3,5 days. We had four operative complications (9.09%). The US and a nuclear scan confirmed the resolution of the UPJO in all patients except one with the Fenger pyeloplasty who had an open Anderson-Hynes. Conclusions: The combination of retroperitoneoscopic and open procedures for dismembered pyeloplasty offers a simple, time-saving method in a minimally invasive fashion with low morbidity for patients with UPJO.

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