2 May 1994 Holmium-laser endopyelotomy
Author Affiliations +
Proceedings Volume 2129, Lasers in Urology; (1994) https://doi.org/10.1117/12.175026
Event: OE/LASE '94, 1994, Los Angeles, CA, United States
The conventional treatment of the obstructive pelviureteric junction (PUJ) is open surgical repair via a loin incision and a pyeloplasty. A funnel-shaped PUJ is constructed by means of sewing in a flap of pelvis into the proximal ureter or a spatulated anastomosis is performed. Wickham suggested that an incision of the PUJ combined with stenting could be performed by means of a percutaneous approach and would replicate a Davis intubated pyeloplasty. Davis had shown that simply incising a narrow PUJ or ureteric stricture followed by stenting for 6-8 weeks would result in the regeneration of muscle and epithelium around the stent to form an unobstructed new structure. The percutaneous approach had a lower success rate than conventional open surgery. Approximately 30% of cases relapsed. These failures could however also be treated by a second incision and stenting. A less invasive modification of the percutaneous approach is to perform the entire procedure via a ureteroscope. This has been performed using large caliber ureteroscopes and electrical incision. We report here the use of a holmium laser to incise the ureter in combination with a miniaturised ureteroscope. It has been shown that large caliber ureteroscopy carries a high complication rate with strictures and perforations. Miniaturised ureteroscopy is safer and easier.
© (1994) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Graham M. Watson, Graham M. Watson, Sunil Shroff, Sunil Shroff, Robert Thomas, Robert Thomas, Michael Kellett, Michael Kellett, } "Holmium-laser endopyelotomy", Proc. SPIE 2129, Lasers in Urology, (2 May 1994); doi: 10.1117/12.175026; https://doi.org/10.1117/12.175026

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