Dismembered Pyeloplasty
Dismembered pyeloplasty is the method of choice, if a crossing vessel is identified as cause for the UPJ obstruction, and probably for most other indications. Traction sutures are placed at the renal pelvis. Excision of the UPJ obstruction is done with, if necessary, excision of excess renal pelvis (reduction pyeloplasty). The ureter is spatulated along the lateral wall (2–3 cm) [fig. dismembered pyeloplasty]. The ureter is repositioned in relation to the crossing vessel, resulting in an anastomosis ventral of the crossing vessels.