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Year : 2009  |  Volume : 25  |  Issue : 1  |  Page : 27-33

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

1 Endourology Society Fellow, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India; Specialist Urology Registrar, London, UK
2 Huddersfield Royal Infirmary, UK
3 Pinderfields General Hospital, Wakefield, UK
4 St James's University Hospital, Leeds, UK

Correspondence Address:
Chandra Shekhar Biyani
Department of Urology, Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, UK

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-1591.45533

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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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