A 23 year old lady presented to us with right sided flank pain on and off since a few years.On USG there was right moderate hydronephrosis.She underwent CT scan KUB which confirmed the findings and there was no calculus anywhere. She was taken up for diuretic renogram which proved delayed transit in right kidney and thus confirming the diagnbosis of right Pelviureteric junction obstruction. We took her for right Anderson -Hynes Pyeloplasty by Laparoscopy. Transperitoneal approach was done.It took around 2 hours.We don't do stenting before the procedure.It helps to keep pelvis distended and makes the PUJ dissection easier. We do stenting after the posterior layer suturing of the pelviureteric anastomosis is done.
Laparoscopic pyeloplasty offers a minimally invasive treatment option that may be used in patients with either primary or secondary UPJ obstruction and is emerging as a new criterion standard in the treatment of UPJ obstruction. Success rates are comparable with those of open pyeloplasty procedures, and some studies have shown that laparoscopy offers the advantages of decreased morbidity, shorter hospital stay, and quicker recovery. Laparoscopic pyeloplasty is a technically demanding procedure that generally requires significant laparoscopic experience.
A small intrarenal pelvis is a relative contraindication to laparoscopic pyeloplasty as the intrarenal dissection would pose difficulty for the laparoscopic surgeon.