A Bridge between Laparoscopic and Open Technique in Treatment of Pediatricpelvi-Ureteric Junction Obstruction for the Beginners Laparoscopic Assisted Pyeloplasty in Pediatric Patients
Iranian Journal of Pediatric Surgery,
Vol. 8 No. 1 (2022),
26 December 2021
,
Page 9-18
https://doi.org/10.22037/irjps.v8i1.36088
Abstract
Introduction: Laparoscopic pyeloplasty is considered one of the most challenging procedures in the paediatric urology. Long operating time and steep learning curve are drawbacks of the technique. The aim of this study is to assess the feasibility of laparoscopy-assisted pyeloplasty and its outcome.
Materials and Methods: It's a retrospective comparative study of patient undergoing pyeloplasty in Shri
Dharmasthala Manjunatheshwara(SDM) College of Medical Sciences since June 2018 !ll February 2020. The pa!ents were divided into two groups based on whether patients have undergone laparoscopy-assisted approach (group A) or open pyeloplasty (group B) and both groups were followed up for one year. Laparoscopy-assisted approach constituted of laparoscopic mobilization of pelvi-ureteric junction (PUJ) followed by hand-sewn anastomosis after exteriorising the PUJ.
Results: There were 12 patients in group A and 16 patients in group B. Duration of surgery was longer in group A. There were 4 pa!ents in group A, older than 3 years who needed conversion to open surgery. One patient had recurrence of PUJO needing re-do surgery. There was no major complication in open technique except
wound infection which required extended hospital stay up to 8 days. There were no significant differences between the two groups in analgesic usage.
Conclusion: Laparoscopy-assisted pyeloplasty is an intermediate path for surgeons with less experience in
advanced laparoscopy. The reasonable small incision without compromising outcome in ureteropelvic anastomosis is the major advantage of this technique. The procedure is useful in infants but not suitable for the age group of above 3 years.
- Laparoscopy assisted pyeloplasty
- Paediatric pyeloplasty
- Minimal invasive surgery for pelviureteric junction obstruction
How to Cite
References
Thomas DFMF: Urology and prenatal diagnosis, in Belman AB, King LR, Kramer SA(eds): Clinical pediatric urology. Martin Dunitz Ltd, 2002, pp 65–81.
Rassweiler J, Rassweiler MC, Kenngott H, et al:The past, present and future of minimally invasive therapy in urology: a review and speculative outlook. Minim Invasive Ther Allied Technol 2013;22(4):200–209.
Maheshwari R, Ansari MS, Mandhani A, et al: Laparoscopic pyeloplasty in pediatric patients: the SGPGI experience. Indian J Urol 2010;26(1):36-40.
Chi YY, Zhou XR, Yang JY:Pyeloureteroplasty and its adjuvant treatment. Chin J Urol 2001;22:142–144
Peters CA:Laparoendoscopic renal surgery in children. J Endourol2000;14(10):841-7; discussion 847-8.
Tan HL: Laparoscopic Anderson-Hynes dismembered pyeloplasty in children. J Urol1999;162(3):1045-7; discussion 1048.
ZamfirSnykers C, De Plaen E, Vermersch S, et al: Is Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction in Infants Under 1 Year of Age a Good Option? Front Pediatr 2019;25(7):352.
Panek W, Szmer J, Kuijper CF, et al: Learning curve or experience-related outcome: what really matters in paediatric laparoscopic pyeloplasty. WideochirInne Tech Maloinwazyjne2020;15(2):377-381.
Lee JH, Zhang J, Wei L, et al: Neurodevelopmental implications of the general anesthesia in neonate and infants. Exp Neurol 2015;272:50-60.
Ansari MS, Mandhani A, Singh P, et al:. Laparoscopic pyeloplasty in children: longterm outcome. Int J Urol 2008;15(10):881-4.
Sheng-Yang, HuangaChou-Ming, YehbChia-ManChouac, et al: Hybrid procedure for pyeloplasty in infants and young children with ureteropelvic junction obstruction is a safe and effective alternative. Formosan Journal of Surgery2014;47(2):53-6.
Masieri L, Sforza S, Cini C, et al:Minilaparoscopic Versus Open Pyeloplasty in Children Less Than 1 Year. J Laparoendosc Adv Surg Tech A 2019;29(7):970-975.
Jayaram H, Chandrasekharam VV: A simple technique of trocar fixation during pediatric laparoscopy with foley catheter sleeve. Indian J Surg 2013;75(4):319-20.
Mohamed Amin El-Gohary: Laparoscopic-Assisted Pyeloplasty in Children. Pediatric Endo surgery & Innovative Techniques 2004;8(3):260-3.
Mohamed Amin El-Gohary: Laparoscopically assisted pyeloplasty for ureteropelvic junction obstruction: a transperitoneal versus a retroperitoneal approach. Ann PediatrSurg2012;8:29–31.
Bajpai M, Khanna K, Khanna V, et al:Lumboscopic-Assisted Pyeloplasty: A Single- Port, Retroperitoneoscopic Approach for Children with Pelvi-Ureteric Junction Obstruction. J Indian Assoc PediatrSurg 2020;25(3):163-168.
Parisa SaeediSharifabad, Mehran Hiradfar, Reza Shojaeian, et al: Laparoscopic- Assisted Extracorporeal Pyeloplasty: A MinimallyInvasive Approach to Pediatric Ureteropelvic Junction Obstruction. Nephro-Urol Mon 2018; 10(5):e83823.
Howe A, Kozel Z, Palmer L: Robotic surgery in pediatric urology. Asian J Urol 2017; 4:55–67.
Morales-López RA, Pérez-Marchán M, Pérez Brayfield M: Current Concepts in Pediatric Robotic Assisted Pyeloplasty. Front Pediatr 2019;7:4.
- Abstract Viewed: 173 times
- PDF Downloaded: 193 times