Ureteropelvic Junction Stenosis-A Personalized Approach

Aim: The video is a presentation of a robotically-assisted laparoscopic dismembered pyeloplasties (RALDP). The surgeon using this technique, must take into account an individual anatomical variants and be conscious of various pelvic reconstruction methods. This is a presentation of three patients treated with a RALDP technique. Methods: Digital video was captured during the intervention for educational purposes. Results: This is a presentation of the classical manouvres used in laparoscopy and robotically-assisted surgery. Standard tools like: bipolar electrocautely, Hem-o-lock polymer ligating clip and ultrasonic sheears were used. Stone removal can be performed at the same time as nephroscopy and RALDP. The lower vessels can be crossed either anteriorly or posteriorly. 52 robotic laproscopic pelvis corrections were performed, 41 of them were RALDP. Lower pole vesseles were directed posteriorly in 13 cases and cephalad in 4 cases. A 95.1% patients resulted normally in the renogram, ordered after the surgery. After cephalad crossing, no stenosis was obsereved. Flank pain disappeared without further treatment in 97.6% (40 out of 41 ) cases. The patient with the persistent pain did not show any stenosis in the laxis renogram examination. Authors: Michelle Lerner MD, Chandru Sundaram MD