Laparoscopic Redo Pyeloplasty: Point of Technique and Our Experience

Abstract

Abstract Introduction: Open dismembered pyeloplasty is a gold standard for managing ureteropelvic junction (UPJ) obstruction resulting in a success rate >90%.1 The conventional open surgery for failed pyeloplasty is very challenging because of the fibrosis and scarring at the previous surgical site. The current options for managing the failed pyeloplasty are endopyelotomy or redo pyeloplasty, which can be an open, laparoscopic or robot-assisted approach.2 The ureterocalicostomy is considered to salvage the kidney when there are no other options. The redo pyeloplasty is equally difficult with both the open and laparoscopic approach. We present a video demonstration of laparoscopic redo pyeloplasty. The port positions are depicted in the illustration. After achieving the pneumoperitoneum, the colon was reflected along the line of toldt. The affected renal unit and dilated renal pelvis were exposed after incising Gerota's fascia. The normal ureter was identified and dissection was continued proximally toward...