Department of Pediatric Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Lane, Elamakkara P.O., Kochi, India.

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To describe a laparoscopy-assisted retroperitoneal pyeloplasty (LARP) and results of initial experience.

Port placement used by Farhat in retroperitoneal-assisted laparoscopic pyeloplasty was modified for better cosmetic results. Surgery was done using 2-cm incision for 5-mm camera port and two 3-mm working ports. Dissection was done anterior to the kidney. The ureteropelvic junction was brought out through the 2-cm trocar site and the pyeloplasty was performed extracorporeally. Between January 2004 and February 2008, a total of 39 kidneys in 38 children with mean age of 4.1 months underwent LARP. The operative time, hospital stay, functional outcome and follow-up renogram studies were reviewed.

The mean operative time was 147 min. 2-cm incision was extended in one patient with malrotated kidney. There was improvement in function in 37 (95%) with no failure. The mean split renal function, preoperative and at follow-up were 35.7 and 44.2%, respectively (P = 0.000). The mean glomerular filtration rate (ml/min), preoperative and at follow-up were 27.4 and 39.1%, respectively (P = 0.000). Mean follow-up period was 24 months.

LARP is safe in treating UPJ obstruction in infants. It is recommended especially in small babies where laparoscopic pyeloplasty is difficult.

Written by:
Abraham MK, Nasir AR, Bindu S, Ramakrishnan P, Kedari PM, Unnithan GR, Damisetti KR.   Are you the author?

Reference:
Pediatr Surg Int. 2009 Jul;25(7):601-5.
doi:10.1007/s00383-009-2394-y

PubMed Abstract
PMID:19517124

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