Laparoscopic transperitoneal pyeloplasty.

Laparoscopic pyeloplasty is a first-line option for the management of ureteropelvic junction obstruction. It has a greater success rate than endopyelotomy and is associated with a shorter and less intense convalescence than open surgical pyeloplasty. The technique is well established and reproducible, although the procedure is more difficult in certain situations, such as after a previous pyeloplasty. Because laparoscopic suturing is needed, it is considered an advanced laparoscopic procedure. Suturing devices can facilitate suturing, but they are not optimal for all repairs. This article and the accompanying video summarize the preoperative, intraoperative, and postoperative considerations for laparoscopic pyeloplasty.