LAPAROSCOPIC DISMEMBERED PYELOPLASTY - PRELIMINARY-REPORT

As a reconstructive laparoscopic procedure, dismembered pyeloplasty wa s done in 5 patients: the laparoscopic procedure was completed in 4 an d converted to an open operation in 1. Within this series operative ti me decreased from 390 to 190 minutes. The main operating time was devo ted to laparoscopic suturing of the anastomosis. Spreading the renal p elvis by either pulling the sutures transcutaneously or with intra-abd ominal stay sutures improved visualization and facilitated the anastom osis. Mean postoperative hospitalization was 8 days (range 7 to 10). A fter a mean followup of 9 months (range 6 to 15) excretory urography a nd renal scintigraphy revealed significant radiographic improvement an d no obstruction in 4 patients. Compared to open pyeloplasty and endo- pyelotomy, laparoscopic pyeloplasty may combine the advantages of open surgery (excision of the stenosis and reduction of the renal pelvis) with those of minimally invasive surgery (minimal postoperative morbid ity), provided the operative time can be shortened and the technique s implified.