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Mini-laparoscopic pyeloplasty in a child using transmesocolic approach

Nasser Simforoosh - Mohammad Hossein Soltani
Endourology Urolaparascopy ,  Pediatric Urology
Urology department of Shahid Labbafinejad Hospital - Tehran - Iran
Mini-laparoscopy - Children - Ureteropelvic junction obstruction - Pyeloplasty

Summary

We performed Mini-laparoscopic dismembered pyeloplasty in a 4 year old boy using transmesocolic approach.

Main Description

                                                                                  Surgical technique

The patient was positioned in 45º lateral decubitus and a 10Fr urethral catheter was inserted. Videoscope was inserted through a 5-mm trocar that was fixed in the umbilicus using open access technique. Two 3.5-mm trocars were utilized in the midline subxiphoid position and in the left lower quadrant at the midclavicular line, respectively, for grasping and suturing. We created a 4-cm window in the mesentery of the descending colon and exposed the UPJ. Dismembered pyeloplasty was done compatible with the standard technique and a 3-Fr ureteral stent was inserted through a 3-mm trocar.

                             

                                                Thereafter, the mesenteric window was closed using 5-0 vicryl suture.

                                                                 

No drain was inserted, and the Foley catheter was removed three days after the operation. We did not suture the skin of 3.5-mm trocars, and only the 5-mm trocar was repaired.

                                                                  

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