Laparoscopic pyeloplasty (IPG46)
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic pyeloplasty.
If the transition from the renal pelvis to the ureter is narrow, the urine will not drain easily and backs up causing dilatation of the collecting system proximal (behind) to that point and enlargement of the renal pelvis. This dilatation of the collecting system is referred to as hydronephrosis. UPJ obstruction is usually congenital, but may also be acquired (i.e. secondary to other disease processes or previous instrumentation).
A pyeloplasty is a surgical procedure that is indicated for a ureteropelvic junction (UPJ) obstruction. The UPJ is the portion of the collection system that connects the renal pelvis (the larger collecting portion of the kidney that is funnel shaped and tapers down to the ureter) to the ureter. The standard intervention for ureteropelvic junction obstruction is open pyeloplasty.
Many individuals with a UPJ obstruction do not realize they have this condition until later in life, when the poorly flowing urine becomes infected, or they begin developing symptoms such as pain.
Although different types of pyeloplasty operations have been described, the ultimate goal is to remove the narrowed portion of the UPJ, refashion the renal pelvis, and attach it to the ureter in a way to allow for easy drainage of urine down the ureter. There are different ways to approach the kidney to perform the operation. These include via a flank incision, subcostal (under the rib) incision, transabdominal approach, or even sometimes through an incision in the back.
M10.2 Endoscopic pyeloplasty
M05.1 Open pyeloplasty
Y75.2 Laparoscopic approach to abdominal cavity NEC
Note:Both coding solutions have been given as historically both have been used for laparoscopic pyeloplasty.
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
- IPG046 Laparoscopic pyeloplasty: guidance (web format)
- IPG046 Laparoscopic pyeloplasty - guidance
- IPG046 Laparoscopic pyeloplasty - information for people considering the procedure, and for the public
- IPG046 Laparoscopic pyeloplasty - Distribution list
- Interventional procedure consultation document - Laparoscopic pyeloplasty
- Overview of laparoscopic pyeloplasty
This page was last updated: 15 June 2012
Information for the public
Implementation tools and resources
- None available
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.