Pyeloplasty: A Transperitoneal Approach

Abstract

Transperitoneal laparoscopic pyeloplasty in children is a very common but at the same time also very challenging procedure. A growing body of literature confirms the feasibility and safety of this minimally invasive procedure. Parallel evidence indicates that laparoscopic pyeloplasty has many advantages for the patient, including shorter hospital stay, less postoperative pain, and better cosmesis. Results and complication rates seem to be at least equal to those of open surgery. However, for many surgeons this procedure remains a challenge, mainly because of the intracorporeal suturing techniques needed. Robot-assisted laparoscopy has the potential to facilitate mastery of the intracorporeal fine suturing necessary to perform a perfect, water-tight anastomosis between the renal pelvis and ureter. This will allow more surgeons to perform this delicate procedure successfully with much better ergonomics.