ABSTRACT
Ureteropelvic junction (UPJ) stenosis is the most common cause of pathological neonatal hydronephrosis. UPJ obstruction may be treated conservatively in some cases, but surgery is indicated if symptoms occur or renal function deteriorates. Pyeloplasty is the procedure of choice for UPJ stenosis. Pyeloplasty can be performed by open laparoscopic or robotic technique. The laparoscopic technique is safe and may be associated with shorter length of hospital stay and reduced complications. Lately, robotic pyeloplasty has been performed with similar results, adding the benefits of easier suturing maneuverability, but with increased costs. Flexdex® is a laparoscopic articulating needle driver that improves maneuverability and ergonomics. In this video, a laparoscopic pyeloplasty with the Flexdex® needle drive is described. The case was treated without any intraoperative complications and with no significant blood loss, and the patient was discharged the day after the procedure. After 90 days of follow-up, there were no complications reported.
Subject(s)
Kidney Pelvis/surgery , Laparoscopy/methods , Plastic Surgery Procedures/methods , Robotics/instrumentation , Ureteral Obstruction/surgery , Urologic Surgical Procedures/methods , Child , Equipment Design , HumansABSTRACT
Endothelin-1 (ET-1) has been associated with the development of hypertension in cyclosporine-treated renal transplant recipients. To clarify this association, this observational study compared ET-1 levels in 33 patients taking cyclosporine therapy versus 10 controls. Three hours after cyclosporine administration, ET-1 levels were higher than in the controls, namely 1.81 + 0.99 versus 1.17 + 0.46 pg/mL (P <.04). These results suggest a role of ET-1 in the pathogenesis of post-renal transplantation hypertension in cyclosporine-treated recipients.
