IF ENDOPYELOTOMY WORKS, WHY NOT EXOPYELOTOMY

Endopyelotomy, performed by the percutaneous or the retrograde approac h, is a safe and effective minimally invasive modality for treatment o f patients with ureteropelvic junction obstruction. However, due to a small but calculated risk of vascular and ureteral injury, the procedu re may not be suitable in a certain group of patients. 'Exopyelotomy', a new term coined for retroperitoneoscopic endopyelotomy, appears to be a logical minimally invasive alternative in such patients. Although , our experience is limited to only four patients, the encouraging res ults and the simplicity of the procedure are good enough reasons for i ts inclusion in the armamentarium of an endoscopic surgeon. As it does not transgress the peritoneal cavity, the ureter and, the renal paren chymal, theoretically, it appears to be reasonably safe.