Outcomes of robot-assisted laparoscopic transperitoneal pyeloplasty procedures: a series of 18 patients.
OBJECTIVE
We evaluated outcomes of our robot-assisted laparoscopic transperitoneal pyeloplasty (RALP) procedures.


METHODS
Between July 2011 and March 2014, 18 RALP procedures were performed at our instutition. Ureteropelvic junction obstruction (UPJO) diagnosis was made based on clinical presentation and intravenous urography. All patients underwent basal and diuretic isotopic renography to evaluate the degree of obstruction and impaired renal function. Anderson-Hynes dismembered pyeloplasty technique was used with a transperitoneal approach by using the da Vinci-S 4-arm surgical robot. Outcomes were assessed retrospectively.


RESULTS
Mean patient age was 31.3±11.7 (13-62) years. Male: female ratio was 9: 9. All procedures were primary surgeries. Of 18 patients, 10 (55.5%) had a crossing vessel and 8 (44.5%) had intrinsic obstruction. Mean operative time was 150.4±17.2 (115-185) minutes. Mean anastomosis time was 21.4±5.5 (10-33) minutes. Mean blood loss during the operation was 33.6±17.3 (10-60) cc. Mean hospital stay was 2.6±1.0 (1-6) days. No conversion to open surgery was required. No intraoperative and perioperative (0-30 days) complication occurred. Readmission rate during perioperative period was 0%. Median follow-up was 16.6±10.3 (3-35) months. Postoperative intravenous urography and renography showed improved results in all cases.


CONCLUSIONS
Due to our experience, RALP is a safe and feasible minimally invasive approach in patients with UPJO with excellent surgical and functional outcomes.
Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Kemal
K
Ener
Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Serkan
S
Altınova
Department of Urology, Yıldırım Beyazıt University Faculty of Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Abdullah Erdem
AE
Canda
Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Muhammet Fuat
MF
Özcan
Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Erem
E
Asil
Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Emre
E
Ürer
Department of Urology, Yıldırım Beyazıt University Faculty of Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Ali Fuat
AF
Atmaca
Department of Urology, Yıldırım Beyazıt University Faculty of Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Ziya
Z
Akbulut
Minimal invasive approach; outcomes; robotic pyleoplasty; uretero-pelvic junction obstruction