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29
th
CONGRESS OF THE ESPU
VD: VIDEO DISPLAY
ESPU Meeting
VD-1 (VS without presentation)
LAPAROSCOPIC URETEROCALICOSTOMY
FOR MALROTATED DIFFICULT PUJ OBSTRUCTION
Mohammad BADER
1
and Abraham CHERIAN
2
1) Great Ormond Street Hospital, Paediatric Urology, London, UNITED KINGDOM - 2) Great Ormond Street Hospital
for Children NHS Foundation Trust, Paediatric Urology, London, UNITED KINGDOM
PURPOSE
Uretero-calicostomy can be particularly useful in children with unfavorable PUJ anatomy i.e high
PUJ in a malrotated kidney, horseshoe kidney, complete intrarenal pelvis or in failed pyeloplasty.
MATERIAL AND METHODS
A 12-year old girl presented with a history of central abdominal pain and UTI. Ultrasound showed
severe hydronephrosis (APD-39 mm) with marked calyceal dilatation and an intrarenal pelvis.
DMSA confirmed 18 % function.
RESULTS
Transperitoneal laparoscopy was performed using two-3 mm working ports and a 5 mm transumbili-
cal port for the telescope. A posterior facing high PUJ in a malrotated kidney was noted. Ureter and
renal pelvis were exposed by reflecting the ascending colon. Proximal ureteric end was transfixed,
ligated and divided. An anterior 2 cm vertical incision over the thinned out lower pole calyx was made
using scissors and ureter spatulated. Uretero-caliceal anastomosis was completed in a running
fashion using 6/0 Monocryl. The calyceal urothelium was clearly identified during the anastomosis.
Standard 4.7Fr JJ stent (removed in 6-weeks) and Foleys urethral catheter were left in situ. Patient
was discharged in 48 hours following removal of catheter.
CONCLUSIONS
Laparoscopic uretro-calycostomy is a feasible, safe and useful technique in suitable or unusual PUJ
anatomy. It can be achieved with just two-3 mm working instruments. The primary port through the
natural umbilical scar in addition achieves good cosmesis.
VD-2 (VS without presentation)
ENDO-URETEROTOMY WITH CUTTING-BALLOON
IN PRIMARY OBSTRUCTIVE MEGAURETER
Alberto PARENTE, Ruben ORTIZ, Laura BURGOS and Jose Maria ANGULO
Gregorio Marañon University Hospital, Pediatric Urology, Madrid, SPAIN
PURPOSE
In the last years, balloon dilatation has become a safe and valid alternative in the treatment of
primary obstructive megaureter (POM). In this video we will demonstrate endo-ureterotomy using
a cutting balloon for POM in case high-pressure balloon dilatation fails.