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Endopyelotomy (laser)

NOTE: Some of the information provided contains graphic, medical images which individuals may find upsetting

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How is the procedure performed?

This is normally performed under a brief general anaesthetic via a telescope passed into the bladder. Guidewires are inserted into the ureteric opening in the bladder and, using X-ray screening, passed up into the kidney. A laser fibre is then used to cut through the narrowed area between the ureter and the kidney.

On occasions, the procedure is performed from above by puncturing the kidney and inserting a larger instrument which is also able to carry a laser fibre.

A ureteric stent is then pushed into the correct position, over one of the guidewires, and the wire is removed once positioning has been confirmed by X-ray.

Video - Laser endopyelotomy

Features of this video (courtesy of Mr Oliver Wiseman)

  • Two guidewires (pale blue with circular stripes) inserted via the ureteric opening up into the kidney
  • Laser fibre (blue) pushed alongside the guidewires, through the telescope
  • Laser beam (red) used to cut through the narrowed & scarred area
  • Opening up of the scarring (compare with the situation at the start of the procedure)