Laparoscopy has been implemented in the pediatric urologic population for many different operative interventions.
Recently, laparoscopic pyeloplasty has been shown to be feasible in the pediatric population with few reports also branching out into the infant and toddler population. This study by Cascio, et al. reviewed their experience with laparoscopic dismembered pyeloplasty in kids under the age of 2 years. It was a retrospective review of patients who underwent a laparoscopic Anderson-Hynes dismembered pyeloplasty. The diagnosis of UPJ obstruction was confirmed on renal sonography and diuretic renogram. All the procedures were done transperitoneal. All patients underwent postoperative diuretic renograms and renal ultrasonography.
They had 38 children with UPJ obstructions that underwent a laparoscopic pyeloplasty. Of these patients, 11 of them were younger than 2 years of age. One had bilateral ureteral pelvic junction obstructions. Two of these patients (17%) required a redo laparoscopic pyeloplasty as well. The operative time ranged from 70-140 minutes and the mean hospital stay was 2 days. Follow-up studies showed normal drainage in all patients except one who after the redo pyeloplasty exhibited significantly improved but still prolonged drainage. They comment that their study suggests that laparoscopic pyeloplasty can now be performed on young children with good results.