OBJECTIVES: To present our experience with the treatment of adult ureteropelvic junction (UPJ) obstruction using a laparoscopic Hellstr  m vascular relocation technique. METHODS: Transperitoneal laparoscopy was performed in 35 @entity1 for the management of @entity4145 . In 9 cases, we identified crossing lower pole vessels and performed the Hellstr  m technique. We discuss our indications, intraoperative techniques, and outcomes when performing only vascular relocation in these @entity1 . RESULTS: All 9 @entity1 presented with long-standing @entity812 and were identified as having @entity4145 (7 primary, 2 secondary) on radiographic imaging. The intraoperative decision to perform the Hellstr  m technique was based on the presence of the crossing vessels, a grossly normal appearance of the ureter and UPJ, and a small renal pelvis. The crossing vessels were completely mobilized, displaced cephalad, and fixed using intracorporeal sutures. The mean operative time and @entity190 was 164 minutes and 15 mL, respectively. At a mean follow-up of 19 months (range 14 to 31), the @entity1 were asymptomatic with no evidence of obstruction on Lasix nuclear renography. CONCLUSIONS: Traditional treatment of @entity4145 , with or without crossing vessels, has been accomplished by pyeloplasty. Dismembered pyeloplasty is a standard method in cases of associated crossing vessels; however, we propose that the Hellstr  m technique be considered in cases in which the ureter appears normal and the pelvic anatomy is unfavorable for transection and anterior reanastomosis of the ureter and pelvis. These considerations are particularly relevant during the laparoscopic approach in which intracorporeal suturing and knot tying are technically challenging.

Hellstr  m technique revisited: laparoscopic management of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity812 :: ('MESH:D021501', 'Disease') :: ['flank pain'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity4145 :: ('MESH:C537373', 'Disease') :: ['UPJ obstruction']
@entity4145 :: (MESH:C537373,Disease) :: ['ureteropelvic junction obstruction']
