CPT® Code 50400

Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple

Pyeloplasty is a surgical procedure aimed at reconstructing the renal pelvis, which is the area of the kidney where urine collects before it moves to the ureter. This operation is typically performed to address congenital conditions, particularly when there is a high insertion of the ureter into the renal pelvis that leads to obstruction. The Foley Y-pyeloplasty technique is one of the most commonly utilized methods for this type of surgery. During the procedure, a skin incision is made over the kidney to access the renal pelvis. The surgeon carefully incises Gerota's fascia and dissects the perirenal fat to expose the kidney and ureter. This exposure allows for a thorough examination of the renal structures, particularly in cases where the renal pelvis is significantly dilated due to upper urinary tract obstruction. The procedure involves creating a Y-shaped incision in the renal pelvis, which facilitates the reconstruction and proper alignment of the ureter. Additional steps may include the placement of nephrostomy or pyelostomy tubes, or ureteral stenting to ensure the ureter maintains its diameter during the healing process. The operation concludes with the anastomosis of the ureter to the renal pelvis and the closure of the surgical site, ensuring that any necessary drains are in place to aid recovery.