If endopyelotomy works, why not ‘exopyelotomy’?

Abstract

Summary. Endopyelotomy, performed by the percutaneous or the retrograde approach, is a safe and effective minimally invasive modality for treatment of patients with ureteropelvic junction obstruction. However, due to a small but calculated risk of vascular and ureteral injury, the procedure may not be suitable in a certain group of patients. ‘Exopyelotomy’, a new term coined for retroperitoneoscopic endopyelotomy, appears to be a logical minimally invasive alternative in such patients. Although, our experience is limited to only four patients, the encouraging results and the simplicity of the procedure are good enough reasons for its inclusion in the armamentarium of an endoscopic surgeon. As it does not transgress the peritoneal cavity, the ureter and the renal parenchymal, theoretically, it appears to be reasonably safe.

Key Words:

• retroperitoneoscopy
• laparoscopy
• endopyelotomy
• exopyelotomy pyeloplasty