Background: Open pyeloplasty has been the gold standard for surgical treatment of PUJ obstruction. Over the last two decades the treatment approach to PUJ obstruction has evolved from open pyeloplasty to various minimally invasive procedures. Laparoscopic pyeloplasty has developed world wide as the first minimally invasive option to match success rate of open pyeloplasty

Method: The study was carried out in our tertiary care centre between 2012 to 2015. 50 adult patients of Primary PUJ Obstruction were included in the study who underwent either Open or Laparoscopic Pyeloplasty. Patient were followed up after 4-6 weeks of surgery and outcome of surgery compared.

Results: Laparoscopic pyeloplasty appears to be a safe and effective alternative to open pyeloplasty in adults. Laparoscopic Pyeloplasty has almost similar short term outcome if renal parameters are compared. A trend toward longer operating time but shorter hospital stay with the laparoscopic approach was noted, although at this point the evidence does not indicate either technique is better than the other.

Conclusions: Laparoscopic Pyeloplasty is a technically sound operation which uses well established principles familiar to urologist. This procedure has a minimal level of morbidity, short hospital stay, better cosmesis compared to open approach. Laparoscopic pyeloplasty has emerged as the standard of care and is here to stay.

Keywords: Laparoscopic; Open Pyeloplasty; Pelviureteric junction (PUJ).