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Open pyeloplasty

Kentaro Mizuno, Yoshiyuki Kojima, Hidenori Nishio, Seiji Hoshi, Yuichi Sato, Yutaro Hayashi
Robot-assisted laparoscopic surgery (RALS) has been increasingly embraced in the fields of adult and pediatric urology, especially in North America and Europe. The advantages of a stable magnified 3-D view, tremor filtering, and motion scaling allow for precise intracorporeal exposure and suturing. Because most surgeries are performed as reconstructive rather than excision procedures, the robotic platform is particularly feasible for the field of pediatric urology. In this review, we summarize the recent viewpoints on RALS, such as pyeloplasty, ureteral reimplantation, bladder neck reconstruction, bladder neck sling, appendicovesicostomy, bladder diverticulectomy, and treatments for ureterocele or ectopic ureters, and we also critically summarize the current status of the literature...
September 27, 2018: Asian Journal of Endoscopic Surgery
İbrahim Erol, Kaan Karamık, Mahmut Ekrem İslamoğlu, Mutlu Ateş, Murat Savaş
PURPOSE: The aim of this study was to evaluate the outcomes of laparoscopic pyeloplasty in children less than 12 months of age. MATERIALS AND METHODS: The records of 20 infants, who had pelviureteric junction obstruction and subsequently underwent LP from January 2013 to November 2016 with at least 1 year of follow-up, were retrospectively reviewed. Patients demographics, the results of preoperative and postoperative imaging studies, perioperative details, complications, and results were noted...
September 25, 2018: Urologia
Peng Hong, Guangpu Ding, Dongdong Zhu, Kunlin Yang, Jinhong Pan, Xuesong Li, Zhipeng Chen, Lei Zhang, Qi Tang, Han Hao, Zhansong Zhou, Liqun Zhou
OBJECTIVE: To compare the outcomes of modified laparoscopic pyeloplasty (LP) and robot-assisted pyeloplasty (RLP) for ureteropelvic junction obstruction (UPJO) in China patients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent modified LP and RLP using a transperitoneal laparoscopic approach at 2 different medical institutions between October 2009 and November 2017. RESULTS: Seventy-six patients underwent modified LP and 140 patients underwent RLP...
September 19, 2018: Urologia Internationalis
Santosh Kumar, Abhishek Chandna, Dharmendar Aggarwal, Shantanu Tyagi, Nripesh Sadasukhi
Uretero-pelvic junction obstruction (UPJO) is a common condition, often presenting in adulthood in developing countries. These cases can pose significant problems owing to late presentation and complications such as infection, stones, and impaired renal function. We present the case of a 28-year-old female who presented to us with recurrent symptoms and impaired drainage following a failed open pyeloplasty and robot-assisted ureterocalycostomy for right UPJO. She was managed by robot-assisted boari flap calycovesicostomy, an innovation which helped in salvaging her kidney; ensuring good drainage in the involved kidney...
August 22, 2018: Journal of Robotic Surgery
G Goetz, M Klora, J Zeidler, S Eberhard, S Bassler, S Mayer, J-H Gosemann, M Lacher
INTRODUCTION:  Surgery for ureteropelvic junction obstruction (UPJO) is performed by both pediatric surgeons (PS) and urologists (URO). The aim of this study was to analyze treatment modalities for UPJO and results in relation to the surgical technique and the operating discipline in Germany. MATERIAL AND METHODS:  Data of patients aged 0 to 18 years were extracted from a major public health insurance (covering ∼5.7 million clients) during 2009 to 2016 and were analyzed for sociodemographic variables, surgical technique, and treating discipline...
August 15, 2018: European Journal of Pediatric Surgery
Minki Baek, Mesrur Selcuk Silay, Jason K Au, Gene O Huang, Rodolfo A Elizondo, Kathleen T Puttmann, Nicolette K Janzen, Abhishek Seth, David R Roth, Chester J Koh
INTRODUCTION: Pediatric robot-assisted laparoscopic (RAL) pyeloplasty has become a viable minimally invasive surgical option for ureteropelvic junction obstruction (UPJO) based on its efficacy and safety. However, RAL pyeloplasty in infants can be a challenging procedure because of the smaller working spaces. The use of the larger 8 mm instruments for these patients instead of the 5 mm instruments is common because of the shorter wrist lengths. OBJECTIVE: We hypothesized that the use of 5 mm instruments for RAL pyeloplasty in infants with smaller working spaces will have comparable perioperative parameters and surgical outcomes in comparison with older children with larger working spaces...
July 6, 2018: Journal of Pediatric Urology
Jens Rassweiler, Jan Klein, Ali Serdar Goezen
Objective: To compare laparoscopic Anderson-Hynes pyeloplasty (LAHP) and retroperitoneal laparoscopic YV-pyeloplasty (LRYVP) in ureteropelvic junction obstruction (UPJ) in presence of a crossing vessels (CV). Methods: Our database showed 380 UPJO-cases,who underwent laparoscopic retroperitoneal surgery during the last 2 decades including 206 non-dismembered LRYVP, 157 dismembered pyeloplasties LAHP, and 17 cases of laparoscopic ureterolysis. Among them 198 cases were suitable for a matched-pair (2:1) analysis comparing laparoscopic retroperitoneal non-dismembered LRYVP (Group 1, n  = 131) and dismembered LAHP (Group 2, n  = 67) in presence of a crossing vessel...
July 2018: Asian Journal of Urology
Abdrabuh M Abdrabuh, Elsayed M Salih, Mahmoud Aboelnasr, Hussein Galal, Abdelbasset El-Emam, Tarek El-Zayat
PURPOSE: We compared endopyelotomy to redo pyeloplasty for the treatment of failed pyeloplasty in children to identify factors that may have an impact on outcome and favor one procedure over the other. METHODS: Of 43 patients with recurrent UPJO, EP was performed in 27 and RP was performed in 16. Age, gender, side, presentation of secondary UPJO, hospital stay, complications and success rates were compared. Success was defined as radiographic relief of obstruction as determined by ultrasound or diuretic renography at latest follow-up...
November 2018: Journal of Pediatric Surgery
Andrew Bergersen, Raju Thomas, Benjamin R Lee
Historically, the gold standard for management of ureteropelvic junction obstruction (UPJO) has been open pyeloplasty. However, continued technological and surgical advances have ultimately led to the robotic approach. Continued advances in minimally invasive surgery have led to shorter hospital stays and hastened recovery. Here we present our step by step guide and video to robotic-assisted laparoscopic pyeloplasty.
May 2018: Journal of Endourology
Martin Habicher, Theodoros Tokas, Thomas Rw Herrmann, Udo Nagele
INTRODUCTION AND OBJECTIVES: Transumbilical laparoendoscopic (LESS) procedures reduce access trauma. Laparoendocopic single-incision triangulated umbilical surgery (SITUS) utilizes straight instruments in a triangulated fashion, via three trocars placed through a single umbilical incision. METHODS: Thirty-two consecutive patients underwent an SITUS pyeloplasty. Access is performed by incision of the umbilical fold by 3/4 of its circumference, a 5-mm camera port, and consequently, cranial and caudal 3 or 5 mm working trocars are placed at a distance of 3-6 cm, thus allowing triangulation...
May 12, 2018: World Journal of Urology
Marc Colaco, Austin Hester, William Visser, Alison Rasper, Ryan Terlecki
Purpose: Performance of minimally-invasive surgery (MIS) is increasing relative to open surgery. We sought to compare the contemporary rates of short-term complications of open versus laparoscopic renal and ureteral surgery in pediatric patients. Materials and Methods: A retrospective cross-sectional analysis of the National Surgical Quality Improvement Program Pediatrics database was performed of all cases in 2014 identified using CPT procedure codes for nephrectomy, partial nephrectomy (PN), ureteroneocystostomy (UNC), and pyeloplasty, and reviewed for postoperative complications...
May 2018: Investigative and Clinical Urology
Céline Khalifa, Geoffrey Boliaki Botombe, Xavier Stephenne, Francis Veyckemans
We report for the first time the anesthetic management of 2 sisters suffering from neonatal ichthyosis and sclerosing cholangitis syndrome. They both presented with neonatal cholestatic jaundice and ichthyosis. The first was admitted for orthotopic liver transplantation at the age of 1 year, and the second patient underwent open pyeloplasty for a pyeloureteric junction syndrome at the age of 4 years. These 2 case reports highlight that, except for the potential difficulties with securing the catheters, dressings and endotracheal tube to the skin, the anesthetic implications of neonatal ichthyosis and sclerosing cholangitis syndrome are mainly related to the liver disease: cirrhosis and portal hypertension...
October 15, 2018: A&A practice
Beatriz Bañuelos Marco, Tom Florian Fuller, Frank Friedersdorff, Ricardo González, Anja Lingnau
Introduction and Objectives: Open dismembered pyeloplasty has been the gold standard treatment for ureteropelvic junction obstruction in children. Laparoscopic pyeloplasty (LP) is becoming a standard procedure, but its acceptance is slow. We report our method for minilaparoscopy (MLP) in children using a tansperitoneal approach with the patient in the lateral flank decubitus which we found technically advantageous. Materials and Methods: Retrospective review of the records of 52 children and adolescents up to 18 years of age who underwent transperitoneal MLP at our institution during March 2012-October 2017 A 5 mm trocar is placed for the camera at the site of the umblicus by open technique, two 3 mm trocars placed in the upper and lower quadrants of the abdomen...
2018: Frontiers in Surgery
Manickam Ramalingam, Senthil Kallappan, Sivasankaran Nachimuthu
INTRODUCTION: Laparoscopic pyeloplasty is becoming the gold standard procedure for pelviureteric junction obstruction. The outcome of pyeloplasty depends on precise pyeloureteral anastomosis. Though in open pyeloplasty interrupted or continuous suture are practiced, in most of the laparoscopic or laparoscopy-assisted robotic pyeloplasty continuous suturing is practiced. After acquiring a 3-dimensional (3D) camera, we prospectively analyzed the suturing time, complication rate, and success rate between interrupted and continuous suturing in laparoscopic pyeloplasty...
April 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Briony K Varda, Ye Wang, Benjamin I Chung, Richard S Lee, Michael P Kurtz, Caleb P Nelson, Steven L Chang
INTRODUCTION: Since 2010, there have been few new data comparing perioperative outcomes and cost between open (OP) and robotic pyeloplasty (RP). In a post-adoption era, the value of RP may be converging with that of OP. OBJECTIVE: To 1) characterize national trends in pyeloplasty utilization through 2015, 2) compare adjusted outcomes and median costs between OP and RP, and 3) determine the primary cost drivers for each procedure. STUDY DESIGN: We performed a retrospective cohort study using the Premier database, which provides a nationally representative sample of U...
February 22, 2018: Journal of Pediatric Urology
Adriana M Pedraza Bermeo, Ana María Ortiz Zableh, Mariangel Castillo, Jaime Francisco Pérez Niño
INTRODUCTION: Postobstructive diuresis (POD) is a polyuric state in which large quantities of salt and water are eliminated after solving a urinary tract obstruction. These patients are at increased risk of severe dehydration, electrolytic disturbances, hypovolemic shock, and death. Ureteropelvic junction obstruction (UPJO) is the most common etiology of collecting system dilatation in the fetal kidney, and a significant number of patients require pyeloplasty. There are limited data regarding prognostic risk factors for POD in this scenario...
June 2018: Journal of Pediatric Urology
Christina P Carpenter, Ashley Rawson, David S Hains, Dana W Giel
Nephrogenic diabetes insipidus (NDI), a rare cause of polyuria and polydipsia in children, is usually managed with medications and careful monitoring of water intake. We present a child who was incidentally found to have right hydronephrosis secondary to ureteropelvic junction obstruction, and was subsequently also diagnosed with NDI. After being medically managed, he underwent open right pyeloplasty. His polydipsia abated within 1 month of surgery, and he has done well off of medications since that time. NDI resolution after correction of obstructive uropathy in adults has been reported, but this represents a novel case in pediatrics...
May 2018: Urology
Mary K Wang, Yi Li, Rachel E Selekman, Thomas Gaither, Anne Arnhym, Laurence S Baskin
INTRODUCTION: Patients undergo pediatric urologic surgery as infants and young children. OBJECTIVE: The purpose of the study was to evaluate the evolution of surgical scars over several years in order to inform parents and surgeons on the true cosmetic impact of pediatric surgery and evaluate patient scar satisfaction. STUDY DESIGN: This was a cross-sectional study where patients who have undergone urologic surgery at a young age are evaluated years later for scar satisfaction via an abbreviated validated questionnaire...
April 2018: Journal of Pediatric Urology
Minki Baek, Mesrur Selcuk Silay, Jason K Au, Gene O Huang, Rodolfo A Elizondo, Kathleen Puttmann, Nicolette K Janzen, Abhishek Seth, David R Roth, Chester J Koh
BACKGROUND: Re-do pyeloplasty after failed open or laparoscopic ureteropelvic junction (UPJ) obstruction correction can be a challenging procedure because of scar formation at the previous anastomosis site and decreased vascularity of the ureter. This study compared the perioperative parameters for pediatric robot-assisted laparoscopic (RAL) primary and re-do pyeloplasties with an emphasis on the intra-operative parameters. MATERIALS AND METHODS: We compared the perioperative parameters of pediatric RAL procedures performed by a single surgeon at a tertiary care children's hospital for both primary ureteropelvic junction obstruction (UPJO) and recurrent UPJO after a previous open or laparoscopic procedure over 2013-2015...
May 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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