Open pyeloplasty is the gold standard in the treatment of congenital ureteropelvic junction obstruction. Several reports have shown that laparoscopic pyeloplasty produces comparable results. In this paper, we report a retrospective study of the transmesocolic approach to the left ureteropelvic junction obstruction in 26 patients. As colon mobilization is avoided, the field remains fairly clear. This direct approach also saves time and is least invasive. One patient was lost for follow-up, and 1 patient is awaiting a renogram. Among the remaining 24 patients, 22 patients had improved drainage (IVU or isotope renogram), and 2 of the patients had stable renal function.

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