Laparoscopic Pyeloplasty in the Infant Younger Than 6 Months—Is it Technically Possible?

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Abstract
Laparoscopic dismembered pyeloplasty is an acceptable option for UPJ obstruction in the pediatric population. We report our initial experience with this approach in infants.Eight infants 3 to 5 months old (mean 4.5) underwent transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction. All patients underwent dismembered pyeloplasty with renal pelvis tapering. Two patients underwent concomitant pyelolithotomy and 1 underwent contralateral nephrectomy. Outcome measures included operative time, length of hospital stay, and resolution of obstruction by ultrasonography and DRI.Mean operative time was 1.8 hours for the pyeloplasty portion. Mean hospital stay was 1.2 days. The stent was removed 6 weeks postoperatively in all patients except 1. This patient, 1 of the 2 patients who underwent concomitant pyelolithotomy, had development of a new stone while the stent was still indwelling. Laparoscopic pyeloplasty resulted in 100% resolution of UPJ obstruction in this series.We believe that laparoscopic dismembered pyeloplasty is technically possible in infants younger than 6 months.