An up-to-date overview of minimally invasive treatment methods in ureteropelvic junction obstruction

Abstract

IntroductionOver the last two decades, minimally invasive treatment options for ureteropelvic junction obstruction have been developed and are bcoming more popular. Multiple series of laparoscopic pyeloplasty have demonstrated high success rates and low perioperative morbidity in pediatric and adult populations, for both the transperitoneal and retroperitoneal approaches. In this review, we aimed to analyze the current status of minimally invasive therapy of ureteropelvic junction obstruction.Material and methodsA PubMed database search was conducted to examine minimally invasive treatments of ureteropelvic junction obstruction.ResultsA large number of cases have been reported for adult patients, confirming that robotic pyeloplasty represents a viable option for either primary or secondary repair. Comparative studies demonstrate similar success and complication rates between minimally invasive and open pyeloplasty in both the adult and pediatric populations. A clear advantage, in terms of hospital stay, of minimally invasive over open pyeloplasty was observed only in the adult population.ConclusionsStudies have shown that minimally invasive pyeloplasty techniques are a safe, effective, and feasible in adult and pediatric populations.

Robotic versus conventional laparoscopic pyeloplasty in children less than 20 kg by weight: single-center experience

“…Open pyeloplasty is still considered to be the gold standard in all age groups as it can be done [8]. On contrary, MIS requires more expertise and comparatively long learning curve (laparoscopy has even longer learning curve than robotic) [9].…”

Laparoscopic-Assisted Extracorporeal Pyeloplasty: A Minimally Invasive Approach to Pediatric Ureteropelvic Junction Obstruction

“…In most cases, pyeloplasty is the method of choice to treat patients with UPJO applied by Treudelem in 1886 for the first time. Although, different methods are proposed to treat UPJO, dismembered pyeloplasty remains the most popular surgical technique for years (4). Surgical pyeloplasty technique is improved during recent decades especially in the era of minimally invasive approach.…”

Laparoscopic renal surgery is here to stay

“…RAPY has been proposed to have an advantage over LPY by having a shorter learning curve and suturing time; however, at present there are no well-designed RCTs comparing effectiveness between LPY and RAPY [63] . Several comparative series have suggested that RAPY benefits from having a shorter operative time when compared with LPY, but no other differences were found [59] , [63] , [64] , [65] . A population-based study using the USA Perspective Database found that the median cost of RAPY was significantly higher than OPY, whilst there was no statistical difference between the median cost of OPY and LPY [50] .…”