Incidence of malrotation of kidney is approximately 5-8 %. We have encounter four cases of posterior malrotation. Instead of view of pelvis, inferior vena cava is seen, which suggests the possibility of posterior malrotation. For laparoscopic pyeloplasty in such a scenario insertion of trans-fascial suture to retract lower pole effectively exposes the pelvis-ureteric junction. The video clip shows the trick.
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