Laparoscopic Pyeloplasty: An Initial Experience From A Regional Centre In Rural Australia

Open dismembered pyeloplasty is the current gold standard in the treatment of Pelviureteric Junction Obstruction (PUJO). However, laparoscopic pyeloplasty has been increasingly reported in the literature as a technique with equal efficacy. Additionally, laparoscopic surgery offers the advantage of being minimally invasive, which may result in less post-operative pain and shorter hospital stays. However, the availability of laparoscopic pyeloplasty is limited by the considerable learning curve required. We present our case series of 9 patients who underwent laparoscopic pyeloplasty at a regional centre. Average operating time was 159 minutes (117-192 mins) and median length of stay was 4 days (3-7 days). There were no conversions to an open procedure. There were no major complications noted. Additionally, 88.9% (8 out of 9) patients had complete alleviation of pain. Our case series represents the experience of a single urological surgeon working at a regional Australian centre and is comparable to that of other series in terms of mean operating times, conversion rates, median nights in hospital and success rates. Potential limitations include the low number of cases. Regardless, our series demonstrates that laparoscopic pyeloplasty is a safe and effective treatment in a regional centre.