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Anything less than 5 cm is going to be tough. How old are the babies you are talking about? Unless its a solitary kidney I think its safe to wait until the baby is at least 3 months not 6 months. That makes your port placement much easier not to mention that the ureter will be a bit bigger and easier to manipulate. Something to consider is this port placement (attached) where the camera is medial to the contralateral ASIS. Gives you quite a bit of room even in the small babies
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You must be logged in to view attached files.in reply to: HIdES for bilateral RAL Pyeloplasties #200sorry…not sure what happened here is the 3 port configuration
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You must be logged in to view attached files.in reply to: HIdES for bilateral RAL Pyeloplasties #198Hi All,
Thought I would chime in. I think this is an awesome way to do bilateral cases and even multi-site cases (upper and lower tract. Here are some pictures. I know Michael Kurtz has tried this approach and seemed to like it. There are two ways to do it. First way is with 3 trocars total. The camera swaps to the port contralateral to the working site. So if doing a right UPJ the camera is the port medial to the LEFT ASIS (Picture 1). When you switch to the left UPJ camera moves to medial to the RIGHT ASIS. Other way if you want an assist port id to place 3 ports at the Pfanensteil line (rather than 2). In this port configuration you to use the contralateral most port as an assist (I.e. if working on a right UPJ the Pfanensteil port medial to the LEFT ASIS is your assist, camera in the Pfanensteil mid line and left working arm medial to right ASIS, right working arm at the umbo). (Picture 2)
Craig Peters (and others) make fun of this port configuration but the post-op appearance is awesome and once you get a bit used to some of the differences it works great.Attachments:
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