An 8-year-old boy with right flank pain was found on ultrasonography and intravenous urography to have hydronephrosis secondary to ureteropelvic junction obstruction with calculi in the lower pole of the right kidney and a fusion anomaly. Transperitoneal laparoscopic dismembered pyeloplasty and removal of calculi was carried out. The patient had uneventful recovery and is doing well at 6 months' follow-up. To our knowledge, this is the first reported case of laparoscopic pyeloplasty with pyelolithotomy in crossed fused ectopic kidneys in the pediatric population.
Vesicovaginal fistula (VVF) may be a complication of prolonged repair or urogynecologic surgery. Failing conservative management, it may be repaired using an abdominal or vaginal approach. We herein report laparoscopic repair of VVF following vaginal hysterectomy and detail the operative steps.
A Boari flap may be required to bridge long defects of the middle and lower ureter to the bladder. Laparoscopic construction of a Boari flap was performed in a patient with a ureteral stricture secondary to iatrogenic injury. The salient steps performed were spatulation of the transected ureteral end, fashioning of a Boari flap from the bladder, end-to-side anastomosis of the ureter to the flap, placement of a stent with the aid of a suction cannula, and closure of the flap over the stent. A Boari flap can be accomplished laparoscopically with minimal morbidity.
Aims:Laparoscopic nephrectomy has become a standardized procedure for removal of benign non-functioning kidneys. We present our experience of retroperitoneoscopic pre-transplant native kidneys nephrectomy. . The mean operative time was similar in the two groups; however, the mean blood loss, postoperative analgesic requirement, complication rate, hospital stay and convalescence period were significantly less in the retroperitoneoscopic group. Conclusion: Retroperitoneoscopic nephrectomy should be offered as the primary treatment modality to patients requiring pretransplant native kidney nephrectomy, except in patients where it is contraindicated.
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