title: Promising functional outcomes obtained with robot-assisted laparoscopic pyeloplasty: a single-center experience.
abstract: 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.
authors.affiliation: Department of Urology, GHU EST (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Ferhi
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.forename: Julie
authors.initials: J
authors.lastname: Rode
authors.forename: Vincent
authors.initials: V
authors.lastname: Misrai
authors.forename: Raphaële
authors.initials: R
authors.lastname: Renard-Penna
authors.forename: Pierre
authors.initials: P
authors.lastname: Conort
authors.forename: Marc-Olivier
authors.initials: MO
authors.lastname: Bitker
authors.forename: Alain
authors.initials: A
authors.lastname: Haertig
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chartier-Kastler
authors.forename: François
authors.initials: F
authors.lastname: Richard
authors.forename: Christophe
authors.initials: C
authors.lastname: Vaessen
mesh_terms: 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