Category: Laparoscopy: Upper Tract - Benign
Introduction & Objective : Management of pelvicureteric junction obstruction (PUJ) with a intrarenal pelvis is challenging.
We illustrate the ideal technique of Ureterocalicostomy
Methods : A 24 years old female patient with Right PUJ obstruction presented with loin pain of2 months duration. Right RGP revealed intrarenal pelvis with gross caliectasis. With patient in right loin position using 4 ports mobilisation of upper ureter revealed intarenal pelvis necessitating ureterocalicostomy . Lateral ureterotomy was carried on to UPJ and continued over opposing aspect of lower calix (lateral calisotomy ) adequately few secondary calculi were removed . posterior layer of ureterocalicotomy was done using 4-0 PDS suture . Then antegrade stenting was done . Subsequently anterior layer suture was completed. postoperative period was uneventful.
Results : Post operatively patient did not have much drainage.
Foley catheter was removed on the 2nd post operative day .
Tube drain was removed on 3rd post operative day .
Patient made smooth recovery.
6 months post operatively diureteic renogram showed good drainage.
Conclusions : This technique of ureterocalicostomy makes UPJ wide system drains better than anastamosing ureter to button- hole calicostomy.
Ramalingam Manickam– Consultant Urologist, Urology Clinic, Coimbatore, Tamil Nadu, India
Senthil Kallappan– Consultant Urologist, MS, MCh(Uro).,FRCS(Edin), Coimbatore, Tamil Nadu, India
Sivasankaran Nachimuthu– Consultant Urologist, MS, MCh(Uro), Coimbatore, Tamil Nadu, India
Coimbatore, Tamil Nadu, India
Manickam ramalingam, MS, MCh, DNB, FRCS - Professor of urology, Consultant Urologist
• APSOGUS, 2005,
• Bimavaram, Andhra Pradesh – Dr.RanganathaRaoOration "Evolution of Laparoscopic reconstructive urology".
• TAPASUCON 2010, Andaman, Dr.Umapathy Endowment Oration- “My Journey through
• URO TAN GOLD MEDAL 2015 in TAPASUCON 2015
• Pinnamaneni Gold medal oration (USI CON 2015), Ranci
• Hon. FRCS from Edin Oct 2014,
• 29 peer- reviewed publications of lap. Urology Articles in International journals,
• 60 abstract publication in international journals,
• Co editor of “Operative Atlas of Laparoscopy Reconstructive Urology” (Springer Publication 2009),
• Editor of BPH (MacMillan Publication 2011),
• Co editor of “Operative Atlas of Laparoscopic and Robotic Reconstructive Urology” (Springer Publication 2017)
• Editor Update in Urology Family physician book,
• Inducted as member of World Journal of Gastrointestinal Endoscopic Editorial Board (2013).
• Faculty for lap workshop about 50 times in many conferences in India and UK, Honkong, China, Malaysia, Myanmar and Nepal.
• Faculty in International conferences
• Conducted Laparoscopic training programme on 38 courses in Coimbatore from 1998 and trained 300 Indian Urologists and 40 Urologists
from (UK, Germany, Japan, Egypt, Saudi Arabia, Oman, Bahrain, Dubai, Malaysia, Singapore, and Nepal)
• Managing Trustee of M.C Foundation and Charity to help the poor students .
Coimbatore, Tamil Nadu, India