title: Robotic management of complicated ureteropelvic junction obstruction.
abstract: OBJECTIVE
  To assess the feasibility and outcomes of robotic pyeloplasty for complicated cases of ureteropelvic junction obstruction (UPJO).
  
  
  METHODS
  Complicated UPJO cases included patients with the following: concomitant multiple or calyceal stones, secondary UPJO (post-ureteroscopy, open or percutaneous surgery), malrotated kidney, horseshoe kidney, ectopic kidney, giant hydronephrosis, poorly functioning kidney (glomerular filtration rate <20 ml/min), non-redundant renal calyces (requiring nephroplication), ptosis of the kidney (requiring nephropexy), long stricture (>2 cm), age <5 or >60 years and duplex pelvis. All cases underwent dismembered robotic pyeloplasty. Data were collected for operative time, blood loss, stone clearance, analgesic usage and time to recovery. Follow-up was done with intravenous urography and dynamic renal scan.
  
  
  RESULTS
  A total of 29 cases underwent dismembered robotic pyeloplasty with an average operative time and blood loss of 130 min and 50 ml. Stone clearance could be achieved in 8 out of 10. The average follow-up period was 15 months with a symptomatic and objective success rate of 96.6% (28/29). No perioperative complications were noted.
  
  
  CONCLUSIONS
  Robotic pyeloplasty for complicated cases of UPJO is feasible, safe and effective, and has a durable success rate.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. nayyarrishi@gmail.com
authors.forename: Rishi
authors.initials: R
authors.lastname: Nayyar
authors.forename: Narmada P
authors.initials: NP
authors.lastname: Gupta
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Hemal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult