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Laparoscopic lower pole vessels transposition for intermittent PUJ obstruction in children

No. 095. Laparoscopic lower pole vessels transposition for intermittent PUJ obstruction in children. Y Heloury *, M O’Brien*, F Becmeur **, H Lardy**, MD Leclair ** Royal Childrens ’ Hospital, Parkville, Victoria, Australia* Nantes University Hospital, France**. Introduction

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Laparoscopic lower pole vessels transposition for intermittent PUJ obstruction in children

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  1. No. 095 Laparoscopic lower pole vessels transposition for intermittent PUJ obstruction in children • Y Heloury*, M O’Brien*, F Becmeur**, H Lardy**, MD Leclair** • Royal Childrens’ Hospital, Parkville, Victoria, Australia* • Nantes University Hospital, France** Introduction The transposition of lower pole vessels (LPV) is increasingly used for correction of intermittent PUJ since the development of laparoscopy • Results • Mean operative time: 90 mn (45-160) • Mean hospital stay: 2 days (1-15) • Postoperative complications: 2 urinomas (1 JJ stent) • Evolution of symptoms • Disapearance of pain: 54/57 • Pain + increased dilatation: 1 (redo- surgery- Anderson Hynes pyeloplasty) • Pain + decrease of dilatation + good drainage: 2 • US • Decrease of the pelvic • size in 53/57 from 31 mm • (19-60) to 9 mm (4-27) • MAG-3 scan (n=36) • Function stable (n=34) or improved (n=2) • Drainage improved in 35 Aim The aim of this study was to determine the results of laparoscopic transposition of LPV • Methods • Retrospective (2003-2011) multicentric study of 57 cases with a median age of 9.8 years (2-17) • Inclusion criteria: symptomatic (pain) intermittent PUJ with LPV • Surgical technique • Lateral transperitoneal approach by laparoscopy (n=43) or robotic (n=14) • Vascular hitch at the anterior • part of the pelvis with • plication by 2 or 3 stiches • No drainage by internal stent • - Evaluation of the results • Modification of the symptoms • AP size of the pelvis on US • Function and drainage on the MAG-3 scan Pre and postoperative size of the pelvis Conclusions The transposition of LPV for intermittent PUJ obstruction is an effective method in selected cases in children. A long-term follow-up is necessary to confirm these preliminary results References 1. Godbole P, Mushtaq IT, Wilcox D, Duffy PG. Laparoscopic transposition of lower pole vessels. The vascular hitch. An alternative to dismemberdpyeloplasty for pelviureteric junction obstruction in children. J PediatrUrol 2006;2:285-9. 2. Nerli RB, Jayanthi VR, Reddy M, Koura A. Pelvi-uretric junction obstruction with crossing renal vessels: a case report of failed laparoscopic vascular hitch. J PediatrUrol 2009;5:147-50. Acknowledgements . Poster presentation sponsor

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