IUPU经腹腹腔镜肾盂成型术治疗成人肾盂输尿管连接处梗阻(附视频)

Modified transperitoneal laparoscopic dismembered pyeloplasty(IUPU technique)in the treatment of pelviureteric junction obstruction

离断式肾盂成型术是治疗肾盂输尿管连接处狭窄的标准术式,开放手术的成功率达到90%以上。在过去20年里,随着手术技术及器械的不断进步,腹腔镜技术得到了飞跃发展并成为治疗肾盂输尿管连接部梗阻的另一主要方式。腹腔镜下按传统术式离断后再吻合,手术操作难度大,而且无法完全保证正确的吻合方向以及较低的吻合张力。基于传统术式,我们改良创新新技术(命名为IUPU技术),将手术方法进行优化,吻合第一针之后再行离断,最大程度的保证了吻合方向及较低的吻合张力,同时降低了操作难度。手术成功率可达96.4%以上,现将该术式经验分享于下。

Dismembered pyeloplasty is the golden standard in the treatment of pelviureteric junction obstruction （UPJO）. The success rate of open procedure is more than 90%. In the last two decades, with the development of the surgical instru- ments, laparoscopic procedure has become another major approach. The traditional transperitoneal laparoscopic dismembered pyeloplasty can not guarantee the right direction of anastomosis and low anastomotic tension. Based on the traditional way, we modified the suture technique （IUPU technique）. The dismembering should be performed after completing half of anastomosis to maintain correct orientation and prevent torsion of anastomosis. The modified suture technique achieved a high success rate （96.4%0）. In this thesis, our experience was reported and shared.