Laparoscopic Ureterocalicostomy

Ureterocalicostomy is indicated mainly in cases with failed pyeloplasty or with a completely intrarenal pelvis.

Laparoscopic ureterocalicostomy is a safe and feasible treatment for selected patients with complicated ureteropelvic junction obstruction, even in the pediatric population.

A laparoscopic ureterocalicostomy is performed to manage the defects. Follow-up includes clinical evaluation, nuclear renography, intravenous urography and serum chemistry.

Results: The procedure can be transperitoneally performed with a 4-port technique. Vascular control of the renal hilum will be indicated with a mean warm ischemia time of 29 min (range 25–32 min). Mean operative time can be 150 min (range 90–210 min) and mean blood loss can be 550 ml (range 100–1,000 ml).

Operations can be performed in the left renal unit in all cases. Post-operative pyelograms has to be verified for adequate renal unit excretion. No significant variations on pre- and post-operative serum chemistry can be verified. At a mean follow-up period of 26 months (range 12–32 months), there will be no evidence of renal function loss which can be demonstrated by nuclear renography.

In experienced hands a difficult procedure such as ureterocalicostomy can be performed by laparoscopy. This is a complex procedure that is indicated in selected cases where the stenosis of the pyeloureteral junction can be associated with an intra-renal pelvis.