Laparoscopic pyeloplasty

When is it needed?

Laparoscopic pyeloplasty is performed in patients with a narrowing or scarring where the ureter attaches to the kidney, which is an inherent anomaly of the urinary tract in most cases.

How is it performed?

In order to perform laparoscopic pyeloplasty, we require 3-4 trocars inserted through the left or right side of the abdomen. After detaching the kidney from the surrounding tissue, and having broad imaging of the blood vessels, the renal pelvis, as well as the upper third of the ureter, we perform a resection of the narrowed ureteropelvic junction. We then insert a thin catheter (such as a double-J stent) which will temporarily drain the kidney and help reconnect the ureter to the kidney pelvis. In most cases, the surgery also entails readjusting the position of the ureter in relation to the kidney’s blood vessels (also known as transposition). The removed segment is placed into an endoscopic bag, which is extracted through one of the trocar incisions. Then, a thin drainage tube is inserted in order to monitor possible post-operative bleeding, the remaining trocars are removed, and the incisions are stitched up.

What are the possible complications?

Complications in these surgeries are very rare. The most common possible complication is bleeding that might require a blood transfusion. There are also general risks of laparoscopic surgery, such as the damage of stomach organs, the diaphragm, or blood vessels. These risks are minimal and occur in less than 1% of all patients. Approximately 1% of laparoscopic pyeloplasty procedures require a conversion to the open surgical approach.