Current role of robot-assisted pyelolithotomy for the management of large renal calculi: a contemporary analysis.
OBJECTIVE
The scope of robot-assisted surgery continues to expand with the application of these systems to management of large upper-tract urinary stones, with or without concomitant pyeloplasty. The known advantages of the robot-assisted approach, including enhanced optics, dexterity, wristed instrumentation, and ergonomics, can facilitate complex reconstruction of the collecting system, including uteropelvic junction repair. With the favorable outcomes of contemporary robot-assisted pyeloplasty series, robot-assisted applications have been translated to pyelolithotomy with or without concomitant upper-tract reconstruction. The early results of robot-assisted lithotomy reveal the procedure is a safe and efficacious approach for patients with large renal stones; nevertheless, the technique has met limited success in cases of large staghorn calculi. Our purpose was to evaluate the current role of robot-assisted pyelolithotomy for the management of large renal calculi.


CONCLUSIONS
Given the known advantages of the robotic system in conjunction with its reconstructive capabilities, the applications of robot-assisted pyelolithotomy, although encouraging, warrant further longitudinal, multi-institutional investigation. This technique is in its early stage of implementation and randomized trials that compare robot-assisted outcomes with other minimally invasive techniques are needed to define clinical efficacy as it pertains to subsets of patients with variable stone size, location, and consistency.
Department of Urology, Columbia University College of Physicians and Surgeons , New York, NY, USA.
Gina M
GM
Badalato
Ashok K
AK
Hemal
Mani
M
Menon
Ketan K
KK
Badani
D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery*; D012371:Robotics; D013520:Urologic Surgical Procedures / Q000379:methods