Robot-assisted laparoscopic pyeloureterostomy in infants with duplex systems and upper pole hydronephrosis: Variations in double-J ureteral stenting techniques. Issue 2 (April 2017)

• Record Type: Journal Article
• Authors: Baek, Minki; Au, Jason; Huang, Gene O.; Koh, Chester J.
• Is Part Of: Journal of pediatric urology. Volume 13:Issue 2(2017)
• Page Start: 219
• Page End: 220
• Publication Date: 2017-04
• Subjects: Robotics -- Laparoscopy -- Children -- Ureteral duplication -- Pyeloureterostomy -- Hydronephrosis; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2016.12.008
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Objective: We describe our experience with robot-assisted laparoscopic (RAL) pyeloureterostomy in infants with duplex systems and upper pole hydronephrosis with an emphasis on the various double J (DJ) ureteral stent placement techniques. Methods: We used our RAL pyeloureterostomy technique in two female infants with duplex systems and upper pole hydronephrosis. For case 1, we introduced the DJ stent and placed it in the recipient lower pole ureter during the robotic operation in an antegrade fashion. For case 2, we inserted the DJ stent during retrograde pyelography prior to the robotic procedure in a retrograde fashion, and the proximal portion of the stent was placed across the anastomosis into the upper pole renal pelvis. Results: Postoperatively, each of the patients were discharged on postoperative day 1 without complications. The postoperative renal ultrasound at 3 months demonstrated marked improvement of the right upper pole hydronephrosis in both patients. Conclusion: RAL pyeloureterostomy represents a minimally invasive option for upper tract reconstruction of duplex systems with upper pole hydronephrosis in infants. The DJ stent can be placed at the beginning or during the procedure. The stent can be placed in the lower pole ureter or across the anastomosis into the upper pole renal pelvis.