title: Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults.
abstract: OBJECTIVE
  To present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults.
  
  
  METHODS
  We retrospectively reviewed all patients from our centre who underwent RAUC, between 2011 and 2015, for secondary PUJO resulting from previous surgical intervention. Six procedures in five patients, including a bilateral RAUC were performed. The median (range) patient age was 33.7 (18-41) years. The outcome variables included operative time, duration of hospital stay, and objective evidence of unimpeded drainage on urography.
  
  
  RESULTS
  The mean (range) operating time was 172 (144-260) min and estimated blood loss was 100 (50-250) mL. There were no conversions to open or laparoscopic surgery, and no intraoperative complications. Two patients had Clavien-Dindo Grade I complications that were managed conservatively and one patient had a Grade IIIb complication, which required balloon dilatation and re-stenting. After a median (range) follow-up of 11 (7-48) months, five of the six renal units had successful outcomes.
  
  
  CONCLUSIONS
  The robot-assisted approach appears to be ideally suited for redo cases demanding fine dissection with meticulous suturing. In our present series of adult patients, we could safely and successfully perform RAUC with minimal morbidity. However, a larger multi-institutional outcome analysis is required to substantiate the role of the robot-assisted approach in performing UC.
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Jaspreet S
authors.initials: JS
authors.lastname: Chhabra
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: S
authors.initials: S
authors.lastname: Balaji Sudharsan
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Shashikant
authors.initials: S
authors.lastname: Mishra
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Ganpule
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Sabnis
authors.affiliation: Department of Urology, Muljhibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Mahesh R
authors.initials: MR
authors.lastname: Desai
keywords: Obstruction; PCNL, percutaneous nephrolithotomy; PUJO, pelvi-ureteric junction obstruction; Pelvi-ureteric junction; RAUC, robot-assisted ureterocalycostomy; Robotics; UC, ureterocalycostomy; Ureterocalycostomy