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1. Highly Advanced Laparoscopic Pyeloplasty at World Class Hospitals
in India
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2. Highly Advanced Laparoscopic Pyeloplasty at World Class
Hospitals in India
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What is Pyeloplasty?
Pyeloplasty is a procedure to remove pelvic ureter junction
obstruction.
A kidney is made up of millions of small units called nephrons
where the blood from the body is filtered and urine is formed. This
urine from all the nephrons then drains into a triangular structure
called renal pelvis from where it is carried to the bladder through
thin tubes called ureters. At times the junction between the renal
pelvis and the ureter gets narrowed or kinked and urine flow is
obstructed. As a result there is a buildup of urine in the nephrons,
causing the dilation of renal pelvis, and the condition is known as
hydronephrosis. This condition can be congenital. Pyeloplasty
procedure helps to repair this obstruction and ensure smooth flow
of urine.

3. Types of Pyeloplasty
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There are different types of Pyeloplasty :
• Open Pyeloplasty
• Laparoscopic Pyeloplasty
• Robot Assisted Pyeloplasty
• Percutaneous Antegrade Pyelotomy
• Retrograde Pyelotomy
• Acucise Endopyelotomy
Open Pyeloplasty : This the most common traditional approach used in which
the cut can be made in the lower back, just under the 12th rib, across the
abdomen or in the flank region. In each case a long cut is made, the skin,
intermediate tissue and muscles are cut till the kidney can be seen. Then the
narrowed portion of the junction is cut and removed and the ureter is reconnected
to the renal pelvis. At times a stent is placed in the narrowed part that keeps the
area patent for easy drainage of urine. After the procedure, muscles, skin and
other tissues are stitched up. Patient has to stay in the hospital for 3-4 days and
the recovery period extends from 1 – 3 months.

4. Types of Pyeloplasty
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• Laparoscopic Pyeloplasty : The procedure was first carried out in 1993 and
since then has steadily gained popularity among patients and surgeons alike. The
steps of the procedure are same as in open pyeloplasty except that small cuts and
microscopic instruments replace the large incisions. Though the procedure requires
advanced skills, the shorter hospital stay and faster recovery make it a more
popular option.
• Robot Assisted Pyeloplasty : The da Vinci robotic surgical system has helped
to overcome many of the challenges imposed by laparoscopy. Robotic surgery is
similar to traditional laparoscopic surgery in that instruments are introduced into
the body through several small incisions and manipulated under video guidance.
Unlike conventional laparoscopy, in which the surgeon's hands are directly linked
to the instruments, in robotic surgery, the surgeon's movements are made in a
console that is remote from the patient and translated by the robotic arms. This
procedure provides more freedom of movement to the wrist and less tremor which
makes the suturing easy.
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5. Types of Pyeloplasty
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• Percutaneous Antegrade Endopyelotomy : In this an incision is made directly
over the region of upper pole of kidney. The nephroscope is inserted through the
incision upto the renal pelvis and narrowed area. Micro instruments are then guided
through the scope with the help of a camera and the narrowed portion is cut. The
ureter and the pelvis are stitched up and a stent is positioned from the pelvis up to
the bladder. The stent is kept in place for about 4-6 weeks. Faster recovery due to a
small incision and lesser blood loss is the main advantage of the procedure.
• Retrograde Endopyelotomy : The procedure is same as above except that
instead of a nephroscope, a ureteroscope is used which is inserted through the
bladder and guided up to the renal pelvis. The narrowed part is removed and the
stent is place from the bladder to the pelvis. This procedure can be performed in an
outpatient setting.
• Acucise Endopyelotomy : This procedure is similar to retrograde pyeloplasty
except that a cutting wire and a balloon catheter is used. The balloon catheter has
the cutting wire attached to it in the front. The balloon is filled with a contrast
medium. The acucise catheter is guided through the bladder up to the pelvis. The
balloon is inflated and position checked using fluoroscope. Then the cutting wire cuts
the narrowed area. A ureteric stent is placed and the catheter is withdrawn.

6. Radical or Laproscopic Pyeloplasty- 4500 US Dollars
Note - Cost Estimate above include stay in a Private Room where a Companion can stay with
the patient surgeon fee, medicines and consumables, nursing care, food and Airport Pick &
Drop. More accurate treatment cost estimates can be provided if medical reports are emailed
to us or after the patient is examined by doctors after arrival at hospital in India and medical
tests are done after admission
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