Pyeloplasty — Open / Laparoscopic / Robotic
Surgical Reconstruction of the Ureteropelvic Junction to Restore Drainage
What is Pyeloplasty — Open / Laparoscopic / Robotic?
Pyeloplasty is the gold-standard treatment for UPJ obstruction causing hydronephrosis. The Anderson-Hynes dismembered pyeloplasty excises the obstructed UPJ segment and performs a spatulated reanastomosis of the renal pelvis to the ureter, creating a widely patent dependent drainage point. Performed via open, laparoscopic, or robotic approaches — all achieving success rates above 95%. The procedure is performed under general or spinal anaesthesia with a hospital stay of 2–4 Days. Success rates reach >95% in appropriately selected patients at experienced centres.
How the Procedure Works
Patient Positioning & Port Placement
For laparoscopic pyeloplasty: patient positioned in modified lateral decubitus; ports placed. For open: flank incision made.
Renal Pelvis Incision
The dilated renal pelvis is incised anteriorly; the ureter is transected just distal to the UPJ obstruction.
Spatulated Anastomosis Planning
The spatulated anastomosis is fashioned: the posterior wall of the renal pelvis is cut to create a dependent drainage point.
Anastomosis Construction
The posterior wall anastomosis is sutured first using continuous 4-0 polyglactin sutures; anterior wall completed.
DJ Stent Placement
A 4.7–6 Fr double-J stent is placed through the anastomosis; drain inserted; ports or wound closed.
Outcomes
Who Needs This Treatment?
- →Anderson-Hynes dismembered pyeloplasty — excision of the obstructed UPJ — is the gold standard for all UPJ repairs.
- →Aberrant lower-pole crossing vessels present in 30–50% of cases are transposed anterior to the anastomosis.
- →Robotic-assisted pyeloplasty offers superior dexterity for suturing in the confined retroperitoneal space.
- →Post-operative success confirmed by a MAG3 diuretic renogram at 3–6 months.
- →The double-J stent placed across the anastomosis is removed at 4–6 weeks as an outpatient procedure.
- →Associated with a definite improvement in renal function and elimination of recurrent stone formation.
"Pyeloplasty is one of surgery's great success stories. With over 95% success rates across all approaches, we reliably restore drainage, relieve pain, and protect kidney function for decades."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.