الفهرس 
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Abstract
PUJO is the most common congenital abnormality of the upper urinary tract. Open pyeloplasty has traditionally been viewed as the reference standard. Endoscopic incision through retrograde and antegrade approaches was developed to provide a minimally invasive alternative to open surgery. However, the overall success rate of these techniques can be approximately 10–25% lower than for open pyeloplasty, particularly in circumstances such as marked hydronephrosis, poor renal function and the presence of an anterior crossing vessel. In addition, endoscopic incisions are associated with a risk of perioperative hemorrhage, with 3–11% of patients requiring blood transfusion. LPP was first introduced in 1993 by Schuessler et al., and it has emerged as an alternative first-line option with success rates that parallel those of the open approach.
The main aim of our study was to evaluate our institution in laparoscopic management of pelvi-ureteric junction obstruction after failed open or laparoscopic surgery for pyeloplasty regarding the technique, the postoperative results and the rate of success.
Mean age of our study group was 29 ± 7.5 years, our study included 14 males and 18 females. Secondary PUJ was on left side in 24 patients, and it was on right side in 8 patients. Mean of operative time (LPP) was 143±30 minutes, ranged from 80 to 185 minutes, and mean of blood loss was 55±36 ml, ranged from 30 to 190 ml. Mean value of hospital stay of our patients was 4.12±1.2 days, ranged from 2 to 7 days, and mean of follow up was 5.6±2.15 months, ranged from 3 to 9 months.
Our success rate was 90.6% and only 3 patients experienced postoperative obstruction. As we observed that both intraoperative and postoperative complications occurred in only 7 patients and 25 of patients not had intraoperative or postoperative complications which was similar to several previous studies.
Conclusion
We concluded that LP is a safe and viable treatment option for secondary PUJO with a low complications rate and a high success rate, mastering laparoscopic skills facilitate dealing with complicated cases of failed PUJO and improve the success rate.