Transmesocolic laparoscopic pyeloplasty

Abstract

Purpose. To conduct a comparative assessment of the effectiveness of transmesocolic and retrocolic approaches
when performing laparoscopic pyeloplasty.
Materials and methods. From July 2018 to August 2023, 40 transperitoneal laparoscopic pyeloplasties were
performed, of which: transmesocolic access in 16 patients, standard retrocolic access in 24 patients. Selection
of patients for the transmesocolic approach was at the discretion of the surgeon, including the criterion of
visual recognition of the renal pelvis and/or ureter through the mesentery of the descending colon. The
transmesocolic approach was used only in young people with pathology localized on the left and malrotation
of the kidney.
Results. Transmesocolic access, compared with retrocolic access, reduced the duration of the operation by an
average of 26 minutes (18.9%) and the patient’s hospital stay by 0,79 days (18.4%). The patency success rate
was 93.7% at a mean follow-up of 12 months for the transmesocolic approach and 95.8% at a mean follow-up
of 12 months for the retrocolic approach.
Conclusions. In a select group of patients, transmesocolic pyeloplasty may represent a faster alternative to the
transperitoneal retrocolic approach and speed recovery with similar success rates.