External stent in laparoscopic pyeloplasty: The K-wire technique

Outcomes and costs analysis of Externalized PyeloUreteral versus internal Double-J ureteral stents after paediatric laparoscopic Anderson-Hynes pyeloplasty

“…After half of the pyeloureteral anastomosis is completed, the nephrostomy stent is loaded on the back of a Kirschner wire (K-wire) 1.6 mm 250 mm (Ortho Solutions, UK) and introduced through the cranially placed working port under direct vision, guided through the open pelvis, into the posterior lower calyx and then through the renal parenchyma to emerge on the surface of the lateral abdominal wall (at the renal angle). [17] The externalized end is left on free drainage for 48 hours, then knotted before patient discharge and J o u r n a l P r e -p r o o f covered under a dressing. At approximately 7 postoperative days, the stent is removed in an ambulatory setting with no need for sedation or GA. DJ stent (Percuflex ™ Plus ureteral stent set) was typically 4.8-French in diameter and was placed in an antegrade fashion.…”

“…The most commonly reported types of urinary diversions used after minimally invasive pyeloplasty in children include the internal DJ stent [9][10][11][12][13] and the EPU stent [9,10,[12][13][14][15][16][17]20,21]. The former can be inserted in an antegrade or retrograde fashion [22] and, generally, needs retrieval by cystoscopy.…”

“…To date, several methods of postoperative renal drainage have been described both for open or minimally invasive procedures performed in children, the most common being the insertion of an internal Double-J ureteral stent (DJ) [9][10][11][12][13] or an Externalized PyeloUreteral (EPU) stent [9,10,[12][13][14][15][16][17].…”

Commentary on ‘External stent in laparoscopic pyeloplasty: The K-wire technique’

“…We were most interested to read about Upasani et al's [1] use of a K-wire technique in laparoscopic pyeloplasty. Indeed, we have been performing laparoscopic pyeloplasty in children since 2013 and have notably improved our technique through the prescription of pelvic training, mastery of the suturing technique, and a number of other tips and tricks.…”

“…We have recently used the K-wire technique https://www.sciencedirect.com/ science/article/pii/S1477513118301761?via% 3Dihub [1] with success. We congratulate Upasani et al on finding an effective, easy way of protecting and safely draining a pyeloureteral anastomosis.…”