Kalabhavi Srinivas K.pdf

Proforma
nephrostomy drainage was introduced in the late 1920s by Papin and Walters. In
1937, Foley modified Schwyzer's Y procedure by extending the upper limbs of the Y
onto the posterior and anterior walls of the renal pelvis. The lower limb of the Y was
extended down the lateral aspect of the ureter. In 1943, Davis described intubated
ureterotomy in which a longitudinal incision is made in the narrowed portion of the
ureter; a tube is left in place for 6 weeks until the ureter regenerates around the tube.
In 1949, Anderson and Hynes described dismembered pyeloplasty (although it was
the method used by Kuster almost 60 years earlier). Their objectives were to excise
the obstructing lesion, resect the redundant pelvis if necessary, and place a dependent
flap of renal-pelvic tissue into the split ureter. Maintenance of ureteral continuity was
considered important by many, and in 1951 and 1953 flap pyeloplasties were
described by Culp and Scardino, respectively. However, as favorable results with the
dismembered pyeloplasties accumulated, it became clear that maintenance of ureteral
continuity was not essential to success and the flap and intubated procedures were
relegated to secondary roles for the treatment of long ureteral strictures.
Laparoscopic pyeloplasty was first performed by Schuessler 60 and coworkers
in 1993 on 5 patients with a mean follow up of 12 months. Recker and associates in
1995 reported an early European experience in 5 patients. Janetschek and colleagues
in 1996 reported their results in Austria with both retroperitoneoscopic and
laparoscopic approaches to both dismembered and non-dismembered pyeloplasty.
Chen and coworkers in 1998 reported laparoscopic pyeloplasty in 44 patients. Baeur
and his associates in 1999 performed a comparative study of the objective and
subjective outcomes of the laparoscopic versus open pyeloplasty in a multicentre
review.