Pyeloplasty

  • Pyeloplasty (flap vs. dismembered; dismembered allows repositioning of ureter if there is a crossing vessel)
    • Open pyeloplasty (peds) (Anderson Hynes)
    • Robotic pyeloplasty 
      • Sheth - ports infraumbilical, suprapubic (camera), and ipsilateral inguinal
        • 2-0 Prolene/PDS for hitch stitch through skin
        • Insert wire through 14 ga angiocath through skin near hitch stitch
  • If not enough pelvis to sew to - ureterocalycostomy 
  • Vascular hitch option for crossing vessel

Post-op

  Kan (open) Sheth (robotic)
Abx 24 hrs amp/gent 24 hrs Kefzol
Fluids 1.5 mIVF D5LR 1.5 mIVF POD0, then wean
Diet Clears, regular diet in AM
Labs Hct and Cr AM of POD1 KUB in PACU for stent
No labs unless hx poor renal function
Meds Wait for Toradol until AM Cr
Usually has epidural
DC toradol POD2		  
Foley Remove POD1 AM  
DC DC penrose and home POD2 Home POD1
author: last edited: Feb. 15, 2021, 10:31 a.m. | pk: 198 | unpublished