ESPU Congress 2018 - Abstract Book

45 11–14 APRIL, 2018, HELSINKI, FINLAND 16:26–16:29 S3-11 (PP) MAGNETIC COMPRESSION ANASTOMOSIS DEVICE TO SIMPLIFY LAPAROSCOPIC PYELOPLASTY- REPORT OF PRELIMINARY EXPERIMENTAL RESULTS Tamas CSERNI  1 , Daniel HAJNAL  2 , Andras NAGY  3 , Daniel URBAN  2 , Daniel ERCES  2 , Rainer KUBIAK  4 , George RAKOCZY  5 , Josef KASZAKI  2 and Supul HENNAYAKE  1 1) Royal Manchester Children's University Hospital, Paediatric Urology, Manchester, UNITED KINGDOM - 2) University of Szeged, Institute of Surgical Research, Szeged, HUNGARY - 3) University of Szeged, Department of Radiology, Szeged, HUNGARY - 4) Klinikum Braunschweig, Pediatric Surgery, Braunschweig, GERMANY - 5) Royal Manchester Children's University Hospital, Paediatric Surgery, Manchester, UNITED KINGDOM PURPOSE The Anderson-Hynes pyeloplasty is a technically challanging laparoscopic procedure. The most difficult part is the laparoscopic suturing of the uretero-pelvic anastomosis. Robotics is still an exepensive alternative. Our aim is to design a cheap purpose-made device to simplify laparoscopic pyeloplasty. MATERIAL AND METHODS After ethical approval laparoscopy was performed in 3 pigs to dissect the pyelo-ureteric junction (PUJ) and create a side-to-side uretero-pelvic anastomosis with magnetic cylinders on a modified "blue stent". The procedures were converted to open due to technical difficulty of inserting a ne- phrosytomy catheter with the magnet into the non-dilated renal pelvis. In 3 further pigs the ureter was first loosely ligated. Six weeks later transperitoneal laparoscopic procedure was successfully used to tailor the dilated renal pelvis and perform a magnetic compression uretero-pelvic anas- tomosis with a modified internal JJ stent. X-rays were performed on day 1, 7 and 14 postop. The animals were sacrificed 6 weeks later, the position of the magnets, the patency of the anastomosis was assessed and Hematoxilin-eosin staining was performed. RESULTS The magnets were found attached to each other on the 7 th day postop. Narrow anastomosis was seen in 3 cases where the magnets moved below or above the anastomosis. Wide and patent anastomosis was found in 3 cases when the magnets remained at the level of the anastomosis 2 weeks after insertion. CONCLUSIONS It is possible to simplify laparoscopic pyeloplasty with a purpose-made magnetic compression device. Our prototype still needs refinements but it may become a cheap alternative of robotics in the future.