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Transmesocolic Approach for Left Side Laparoscopic Pyeloplasty: Comparison with Laterocolic Approach in the Initial Learning Period

 Hyun Ho Han  ;  Won Sik Ham  ;  Jang Hwan Kim  ;  Chang Hee Hong  ;  Young Deuk Choi  ;  Sang Won Han  ;  Byung Ha Chung 
 Yonsei Medical Journal, Vol.54(1) : 197-203, 2013 
Journal Title
 Yonsei Medical Journal 
Issue Date
PURPOSE: To evaluate the outcome of transmesocolic (TMC) laparoscopic pyeloplasty compared with conventional laterocolic procedure for surgeons with limited experience. MATERIALS AND METHODS: We started laparoscopic pyeloplasty for ureteropelvic junction obstruction in 2009. Since then, 21 patients of left side disease have undergone this surgery in our institution. To access the left ureteropelvic junction, we used the conventional laterocolic approach in 9 patients, while the transmesocolic approach was used in the remaining 12 patients, and perioperative results and follow-up data were then compared. RESULTS: The mean operative time using the transmesocolic approach was significantly shorter than the conventional laterocolic approach (242 vs. 308 min, p=0.022). Furthermore, there was no complication or open conversion. Postoperative pain was significantly decreased in the TMC group (2.8 vs. 4.0 points, measured using the visual analogue scale on the first postoperative day, p=0.009). Postoperative complications were encountered in two patients. All patients were symptom-free after 1 year of follow-up, and radiologic success rates for each group were 92 and 89%, respectively. CONCLUSION: Direct exposure of the ureteropelvic junction via the mesocolon saves time during the colon mobilization procedure. The approach is safe and feasible even for surgeons with limited experience, and has success rates similar to those of the conventional laterocolic approach.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
김장환(Kim, Jang Hwan) ; 정병하(Chung, Byung Ha) ; 최영득(Choi, Young Deuk) ; 한상원(Han, Sang Won) ; 함원식(Ham, Won Sik) ; 홍창희(Hong, Chang Hee)
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