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Minimally invasive surgical options for ureteropelvic junction obstruction: A significant step in the right direction

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Author(s): Symons Stephanie | Palit Victor | Biyani Chandra | Cartledge Jon | Browning Anthony | Joyce Adrian

Journal: Indian Journal of Urology
ISSN 0970-1591

Volume: 25;
Issue: 1;
Start page: 27;
Date: 2009;
Original page

Keywords: Acucise | balloon dilatation | endopyelotomy | laparoscopy | pelviureteric junction obstruction | robotic

ABSTRACT
Open pyeloplasty is the gold standard treatment for adult ureteropelvic junction obstruction (UPJO) with published success rates consistently over 90%. In recent years, the management of UPJO has been revolutionized by the introduction of endoscopic procedures and laparoscopic techniques. We analyzed the long-term results of endoscopic and other minimal access approaches for the treatment of UPJO. Early results for endopyelotomy were promising but long-term results were not encouraging. Laparoscopic pyeloplasty technique is well defined and duplicates the surgical principles of conventional open pyeloplasty. With such a large variety of minimally invasive procedures for the treatment of UPJO available, the treatment choice for UPJO must be based on the success and morbidity of the procedures, the surgeon′s experience, the cost of the treatment, and the patient′s choice. We feel that with the technological advances in instrumentation coupled with a decrease in cost and improved training of urological surgeons, laparoscopic pyeloplasty may evolve to be the new "gold" standard for the treatment of UPJO.

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