Laparoscopic Dismembered Pyeloplasty in PUJ Obstruction with Incidentally Detected Double Crossing Arteries: Expanded Technical Insights and Literature Review
Dr. D R Dhawan (Consultant Urology)
Year: 2025, Volume: 1, Issue: 4, Pages 241-248, Date of Publication: 28 February 2025
Abstract- Laparoscopic Dismembered Pyeloplasty is the gold standard for managing Pelvi-ureteric junction (PUJ) obstruction, offering minimal invasiveness and excellent functional outcomes. However, the presence of Aberrant crossing vessels poses technical challenges, requiring meticulous dissection and vascular preservation. This study presents a case of PUJ obstruction with incidentally detected Double crossing arteries managed via laparoscopic Dismembered Pyeloplasty. We provide expanded technical insights, including intraoperative strategies for vascular identification, Ureteral Repositioning, and anastomosis optimization to ensure long-term patency. Additionally, we review the existing literature on anatomical variations and their impact on surgical outcomes. This report aims to enhance the understanding of complex PUJ obstruction cases and refine laparoscopic techniques for improved patient care.
Keywords- Laparoscopy, Dismembered Pyeloplasty, Pelvi-ureteric Junction, Aberrant vessel, Ureteral Repositioning, Double crossing arteries