Promising functional outcomes obtained with robot-assisted laparoscopic pyeloplasty: a single-center experience.
OBJECTIVE
To assess the effectiveness of robot-assisted pyeloplasty in patients with clinically symptomatic ureteropelvic junction obstruction (UPJO).


METHODS
We retrospectively reviewed our database for all patients who were treated for UPJO by a single surgeon using a robot-assisted procedure between 2005 and 2007. We collected the following: Patient age, clinical presentation, perioperative data, complications, length of hospital stay, and outcome. Preoperative evaluation of UPJO always included an injected renal CT scan and furosemide-mercaptoacetyltriglycine (MAG-3) renal scintigraphy. Patients were seen at 3 and 6 months after surgery and once a year thereafter. Postoperative success was defined as symptomatic response and radiographic evidence of no further obstruction.


RESULTS
Twenty patients with a mean age of 36.8 +/- 16 years (range 15-69 yr) were included. Six (30%) patients had previously undergone endoscopic treatment. The mean operative time was 150.3 +/- 36.22 minutes (range 150-240 min). The mean follow-up was 19.9 +/- 10.03 months (range 3-37 mos). Two (10%) procedures necessitated conversion to laparoscopic procedures, and there was no conversion to laparotomy. Four (20%) patients experienced minor complications: Two urinary tract infections and two urinomas. Repeated early surgery was needed in one patient for temporary (ie, 8 days) stent placement in the case of urinoma. There was no recurrence of the UPJO, and no repeated surgery was deemed necessary during the follow-up period. The success rate was estimated to be 95%.


CONCLUSIONS
Functional outcomes after robot-assisted procedures for alleviation of UPJO are very promising. Our data showed that the robot-assisted procedure was safe and featured negligible morbidity. Therefore, we conclude that our approach is a viable alternative to open surgery.
Ferhi
Karim
K
Department of Urology, GHU EST (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France.
Rouprêt
Morgan
M
Rode
Julie
J
Misrai
Vincent
V
Renard-Penna
Raphaële
R
Conort
Pierre
P
Bitker
Marc-Olivier
MO
Haertig
Alain
A
Chartier-Kastler
Emmanuel
E
Richard
François
F
Vaessen
Christophe
C
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011300:Preoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D012371:Robotics / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery