Surgery of uretero-pelvic junction obstruction (UPJO) |
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| Institution: | 1. Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria;2. Department of Pediatric Surgery, Lucerne Children''s Hospital, Luzern, Switzerland;1. Division of Pediatric General and Thoracic Surgery, Children''s Mercy Hospital, Kansas City, MO, United States;2. Division of Paediatric Surgery, University of Cape Town, Cape Town, South Africa;3. Division of Pediatric Surgery, University of North Carolina, Chapel Hill, NC, United States;1. Department of Pediatric Surgery and Pediatric Urology, University Children´s Hospital Tuebingen, Tuebingen, Germany;2. Department of Radiation Oncology, University Hospital Tuebingen, Tuebingen, Germany;3. Department of Radiotherapy and Radiation Oncology, University Hospital, Homburg, Germany;4. Department of Particle Therapy, West German Proton Therapy Centre, University Hospital Essen, Essen, Germany;1. Section of Pediatric Surgery, Department of Surgery, UChicago Medicine, Comer Children’s Hospital, Chicago, IL and Advocate Children’s Hospital, Park Ridge, IL, United States;2. Department of Surgery, University of Louisville School of Medicine, Norton Children''s Hospital, Louisville, KY, United States;3. Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children''s Hospital of Chicago, Chicago, IL, United States;1. Department of Pediatric Surgery and Urology, University Hospital Arnau de Vilanova, Lleida, Spain;2. Division of Pediatric Surgery, Exequiel Gonzalez Cortes Children´s Hospital, Clinica Las Condes Medical Center, Santiago, Chile;3. Division of Pediatric Surgery, Luis Calvo Mackenna Children´s Hospital, University of Chile, Clinica Las Condes Medical Center, Santiago, Chile;1. Pediatric Surgery, Children''s Hospital Lucerne, 6000 Lucerne 16, Switzerland;2. Pediatric Urology, Children''s Health UT Southwestern Medical Center, Dallas, TX, United States |
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| Abstract: | Uretero-pelvic junction obstruction (UPJO) is the most common cause of hydronephrosis in infants and children. Historically, this condition has been approached surgically through a retroperitoneal approach as described by Anderson and Hynes aiming for an open dismembered pyeloplasty. A true evolution of laparoscopy in pediatric urology took place within the last 30 years. Laparoscopy developed from a merely diagnostic tool for non-palpable testes to “interventional” laparoscopy for extirpative surgery. Finally the era of reconstructive pediatric laparoscopic urology started, when in 1995 Peters described the first laparoscopic pyeloplasty in a child. Laparoscopic dismembered pyeloplasty now has become the preferred surgical treatment of UPJO. It offers excellent visualization of the anatomy, accurate anastomotic suturing, thus the precise reconstruction of the UPJ along with good functional outcome. This article aims to provide the current status, indication and operative technique of laparoscopic dismembered pyeloplasty for UPJO in infants and children. |
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