Techniques in minimally invasive transperitoneal pyeloplasty: A compilation

Context: Minimally invasive management (laparoscopic/robot assisted) is currently the standard of care for managing pelvi ureteric junction obstruction (PUJO). Open techniques of management of PUJO are well described in literature. However, there appears to be relative lack of description of minimally invasive techniques in the literature. Objective: This article is aimed at describing in detail, with images, the various techniques and modifications in laparoscopic or robot-assisted management of PUJO. Evidence Acquisition: A review of literature on PubMed was performed and all articles which detailed any technique of minimally invasive pyeloplasty were included. Evidence Synthesis: The various techniques of minimally invasive pyeloplasty as well as the authors' techniques are compiled and described in detail with intraoperative images. Conclusions: Operative techniques of minimally invasive pyeloplasty are not well described in literature. We have attempted to present a comprehensive resource of different techniques of minimally invasive pyeloplasty and the clinical scenarios in which they may be appropriate. This should prove to be a useful reference to the practicing urologist. Patient Summary: In this paper, we have compiled the various surgical techniques of treating obstruction at the PUJ of the kidney along with intraoperative photograph.