Robotic management of complicated ureteropelvic junction obstruction.
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.
Nayyar
Rishi
R
Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. nayyarrishi@gmail.com
Gupta
Narmada P
NP
Hemal
Ashok K
AK
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