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Pyeloplasty

  • Boris Chertin
  • Prem Puri
Chapter
Part of the Springer Surgery Atlas Series book series (SPRISURGERY)

Abstract

Widespread use of maternal ultrasound has significantly changed the practice of paediatric urology. Pelvi-ureteric junction (PUJ) obstruction is the most common cause of hydronephrosis detected antenatally. Controversy continues on the optimal timing of surgical intervention in children with antenatally detected hydronephrosis. The decision to intervene surgically in these infants has become more complex because spontaneous resolution of antenatal and neonatal upper urinary tract dilatations is being increasingly recognized. The gold standard surgical procedure for PUJ obstruction is the Anderson-Hynes dismembered pyeloplasty, traditionally performed with an open flank approach. Recent technological advances and a shift across all surgical fields to embrace minimally invasive surgery have led to increased utilization of minimally invasive pyeloplasty. Laparoscopic pyeloplasty has the technical challenges of precise suturing in a confined space and also considerable learning curve. Robotic technology in recent years, has simplified the minimally invasive approach, offering enhanced visualization and improved dexterity with a fairly short learning curve.

Keywords

Pyeloureteric junction obstruction Pyeloplasty Laparoscopy Robotic Pediatric 

Suggested Reading

  1. Chertin B, Rolle U, Farkas A, Puri P. Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi-ureteric junction obstruction? BJU Int. 2002;90:72–5.CrossRefGoogle Scholar
  2. Chertin B, Pollack A, Koulikov D, Rabinowitz R, Hain D, Hadas-Halpren I, Farkas A. Conservative treatment of ureteropelvic junction obstruction in children with antenatal diagnosis of hydronephrosis: lessons learned after 16 years of follow-up. Eur Urol. 2006;49:734–8.CrossRefGoogle Scholar
  3. Kocherov S, Lev G, Chertin L, Chertin B. Extracorporeal ureteric stenting for pediatric laparoscopic pyeloplasty. Eur J Pediatr Surg. 2015; [Epub ahead of print] PubMed PMID: 25774958Google Scholar
  4. Puri P, Chertin B. Upper urinary tract obstructions. In: Puri P, editor. Newborn surgery. 4th ed. London. CRC Press; 2018 p1057–71.Google Scholar
  5. Schuessler WW, Grune MT, Tecuanhuey LV, Preminger GM. Laparoscopic dismembered pyeloplasty. J Urol. 1993;150:1795–9.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Boris Chertin
    • 1
    • 2
  • Prem Puri
    • 4
    • 5
    • 6
    • 3
  1. 1.Department of Pediatric UrologyShaare Zedek Medical CenterJerusalemIsrael
  2. 2.Faculty of MedicineHebrew UniversityJerusalemIsrael
  3. 3.National Children’s Research Centre, Our Lady’s Children’s HospitalDublinIreland
  4. 4.University College DublinDublinIreland
  5. 5.UCD Conway Institute of Biomolecular and Biomedical ResearchDublinIreland
  6. 6.Beacon HospitalDublinIreland

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