Light‐guided renal cyst fenestration during laparoscopic ureterocalicostomy in a patient with left ureteropelvic junction obstruction

• Main Authors: Kazumitsu Yamasaki, Masahiro Uchida, Yukiko Nishijima, Akio Hoshi, Hiroyuki Nishiyama
• Format: Article
• Language: English
• Published: Wiley 2020-01-01
• Series: IJU Case Reports
• Subjects: laparoscopic pyeloplasty; laparoscopic ureterocalicostomy; light‐guided laparoscopic renal cyst fenestration; renal cyst; ureteropelvic junction obstruction
• Online Access: https://doi.org/10.1002/iju5.12129

Introduction Laparoscopic ureterocalicostomy is a useful alternative to laparoscopic pyeloplasty for treating ureteropelvic junction obstruction under certain conditions. One concern regarding this technique is the inevitability of amputation of the renal lower pole to expose the lower renal calyx. Case presentation A 43‐year‐old man who presented ureteropelvic junction obstruction and multiple renal cysts underwent laparoscopic pyeloplasty, which could not be performed because of the intrarenal ureteropelvic junction. We switched the surgical technique to modified laparoscopic ureterocalicostomy, wherein amputation of the lower renal pole was substituted with fenestration of a renal cyst under the guidance of ureteroscopic light. Computed tomography performed 2 months postoperatively showed good patency of the anastomosis. Conclusion Light‐guided laparoscopic renal cyst fenestration followed by ureterocalicostomy is feasible in patients with ureteropelvic junction obstruction and lower pole renal cysts adjacent to the lower renal calyx.