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JSLS. 2014 Jan-Mar;18(1):110-5. doi: 10.4293/108680813X1369342251983.

Robotic laparoscopic pyeloplasty.

Author information

1
Division of Urology, University of São Paulo School of Medicine, São Paulo, Brazil. mariochammas@usp.br.
2
Division of Urology, University of São Paulo School of Medicine, São Paulo, Brazil.
3
Department of Urology, University Henri Poincare/CHU Nancy, Vandoeuvre-lèsNancy, France.

Abstract

BACKGROUND AND OBJECTIVES:

We aimed to assess the feasibility and outcomes of complex ureteropelvic junction obstruction cases submitted to robotic-assisted laparoscopic pyeloplasty.

METHODS:

The records of 131 consecutive patients who underwent robotic-assisted laparoscopic pyeloplasty were reviewed. Of this initial population of cases, 17 were considered complex, consisting of either atypical anatomy (horseshoe kidneys in 3 patients) or previous ureteropelvic junction obstruction management (14 patients). The patients were divided into 2 groups: primary pyeloplasty (group 1) and complex cases (group 2).

RESULTS:

The mean operative time was 117.3 ± 33.5 minutes in group 1 and 153.5 ± 31.1 minutes in group 2 (P = .002). The median hospital stay was 5.19 ± 1.66 days in group 1 and 5.90 ± 2.33 days in group 2 (P = .326). The surgical findings included 53 crossing vessels in group 1 and 5 in group 2. One patient in group 1 required conversion to open surgery because of technical difficulties. One patient in group 2, with a history of hemorrhagic rectocolitis, presented with peritonitis postoperatively due to a small colonic injury. A secondary procedure was performed after the patient had an uneventful recovery. At 3 months, significant improvement (clinical and radiologic) was present in 93% of cases in group 1 and 88.2% in group 2. At 1 year, all patients in group 2 showed satisfactory results. At a late follow-up visit, 1 patient in group 1 presented with a recurrent obstruction.

CONCLUSIONS:

Robotic pyeloplasty appear to be feasible and effective, showing a consistent success rate even in complex situations. Particular care should be observed during the colon dissection in patients with previous colonic pathology.

PMID:
24680152
PMCID:
PMC3939324
DOI:
10.4293/108680813X1369342251983
[Indexed for MEDLINE]
Free PMC Article

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