Pelvic sleeve pyeloplasty in adults: A technical refinement of Anderson–Hynes dismembered pyeloplasty
- 1Department of Surgery, Melbourne Medical School The University of Melbourne Melbourne Victoria Australia
- 2Department of Urology Western Health Melbourne Victoria Australia
- 3Department of Urology The Royal Melbourne Hospital Melbourne Victoria Australia
Abstract
Objectives: To describe pelvic sleeve pyeloplasty, a technical refinement of Anderson–Hynes dismembered pyeloplasty for adult ureteropelvic junction obstruction, and to report perioperative and functional outcomes in an initial adult series.
Methods: Between 2009 and 2018, 12 adult patients with symptomatic ureteropelvic junction obstruction underwent pelvic sleeve pyeloplasty using a transperitoneal laparoscopic or robot‐assisted approach. Preoperative evaluation included computed tomography intravenous pyelography and diuretic Tc‐99m MAG3 renography. Patients with previous failed ureteropelvic junction surgery were excluded. The technique preserves and incorporates a sleeve of renal pelvic tissue into the reconstruction to create a broad, continuous, tension‐free ureteropelvic anastomosis while minimizing manipulation of healthy ureteric tissue.
Results: All procedures were completed successfully without conversion to open surgery. Eight patients underwent laparoscopic and four underwent robot‐assisted pyeloplasty. Mean operative time was 185 min (range 160–255 min), and estimated blood loss ranged from 90 to 350 mL. One patient had intraoperative bleeding from a gonadal vein injury, controlled without transfusion. One patient developed a transient postoperative febrile episode (Clavien–Dindo grade II). No patient developed urinary leakage or required secondary intervention. At a mean follow‐up of 38 months (range 24–50 months), all patients were asymptomatic and diuretic Tc‐99m MAG3 renography demonstrated unobstructed drainage.
Conclusions: Pelvic sleeve pyeloplasty is a feasible modification of dismembered pyeloplasty that preserves ureteric length, minimizes ureteric manipulation and facilitates a wide, continuous, tension‐free ureteropelvic anastomosis. Larger comparative studies are required to validate reproducibility and long‐term efficacy.
Related
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- Ultrasonographic changes following pyeloplasty in children with ureteropelvic junction obstruction: a prospective observational before-after cohort study
- Surgical procedure and efficacy of KangDuo robot-assisted pyeloplasty for horseshoe kidney
- Comparison of outcomes of open, laparoscopic, and robot-assisted laparoscopic pyeloplasty in children with pelviureteric junction obstruction: a systematic review and meta-analysis
- Analysis of the relevant risk factors for reobstruction after laparoscopic unilateral pyeloplasty in children.
BibTeX
@article{agarwal2026pelvic,
title = {{Pelvic sleeve pyeloplasty in adults: A technical refinement of Anderson–Hynes dismembered pyeloplasty}},
author = {Dinesh K. Agarwal},
journal = {BJUI compass},
year = {2026},
month = nov,
doi = {10.1002/bco2.70301},
url = {https://europepmc.org/article/PMC/PMC13727715},
note = {CC BY},
}
RIS
TY - JOUR
TI - Pelvic sleeve pyeloplasty in adults: A technical refinement of Anderson–Hynes dismembered pyeloplasty
AU - Dinesh K. Agarwal
PY - 2026
DA - 2026/11/01
JO - BJUI compass
DO - 10.1002/bco2.70301
UR - https://europepmc.org/article/PMC/PMC13727715
AB - Objectives: To describe pelvic sleeve pyeloplasty, a technical refinement of Anderson–Hynes dismembered pyeloplasty for adult ureteropelvic junction obstruction, and to report perioperative and functional outcomes in an initial adult series. Methods: Between 2009 and 2018, 12 adult patients with symptomatic ureteropelvic junction obstruction underwent pelvic sleeve pyeloplasty using a transperitoneal laparoscopic or robot‐assisted approach. Preoperative evaluation included computed tomography intravenous pyelography and diuretic Tc‐99m MAG3 renography. Patients with previous failed ureteropelvic junction surgery were excluded. The technique preserves and incorporates a sleeve of renal pelvic tissue into the reconstruction to create a broad, continuous, tension‐free ureteropelvic anastomosis while minimizing manipulation of healthy ureteric tissue. Results: All procedures were completed successfully without conversion to open surgery. Eight patients underwent laparoscopic and four underwent robot‐assisted pyeloplasty. Mean operative time was 185 min (range 160–255 min), and estimated blood loss ranged from 90 to 350 mL. One patient had intraoperative bleeding from a gonadal vein injury, controlled without transfusion. One patient developed a transient postoperative febrile episode (Clavien–Dindo grade II). No patient developed urinary leakage or required secondary intervention. At a mean follow‐up of 38 months (range 24–50 months), all patients were asymptomatic and diuretic Tc‐99m MAG3 renography demonstrated unobstructed drainage. Conclusions: Pelvic sleeve pyeloplasty is a feasible modification of dismembered pyeloplasty that preserves ureteric length, minimizes ureteric manipulation and facilitates a wide, continuous, tension‐free ureteropelvic anastomosis. Larger comparative studies are required to validate reproducibility and long‐term efficacy.
SN - 2688-4526
ER -