Da Vinci robot assisted Anderson-Hynes dismembered pyeloplasty: technique and 1�year follow-up

Abstract

In experienced hands, laparoscopic pyeloplasty is an effective alternative treatment for symptomatic ureteropelvic junction obstruction (UPJO). Although laparoscopic surgery can clearly benefit patients, laparoscopic pyeloplasty using conventional instrumentation is complex. The purpose of this report is to evaluate the feasibility of robot assisted laparoscopic surgery. Eleven pyeloplasties for UPJO were performed via a laparoscopic transperitoneal approach exclusively with the da Vinci Surgical System. The mean procedure time was 197 min (range 110-310 min). All operations were completed laparoscopically with no intraoperative complications and negligible blood loss. All patients recovered rapidly after surgery with excellent functional results at the 1 year follow-up. Our initial experience suggests that robot assisted Anderson-Hynes pyeloplasty is a safe and effective alternative to conventional laparoscopic surgery. In our opinion, robot assisted surgery will allow urologists to perform complex procedures with greater precision, confidence, and better results, as well as enable them to adapt the whole spectrum of laparoscopic procedures to their field.

Pathophysiology and treatment of ureteropelvic junction obstruction

“…Gettman et al [31] showed shorter operative time and anastomotic time with robotic pyeloplasty versus standard laparoscopy. Bentas et al [32] showed a 100% success rate of 11 patients that underwent robotic pyeloplasty at a 1-year follow-up. They had no previous experience with laparoscopic pyeloplasty before using the da Vinci robot, and they felt telerobotics enabled inexperienced urologists to perform complex reconstructive surgery with better results than standard laparoscopy.…”

Robot Assisted Laparoscopic Pyeloplasty: a review of the current status

“…Bentas et al reported the first 12 month study on pyeloplasties performed entirely using the da Vinci robot (17). Their series had 11 patients who underwent IVP or ultrasound at 3 and 12 months, with a diuretic renal scan performed at 3 months.…”

Endopyelotomy in the Age of Laparoscopic and Robotic-Assisted Pyeloplasty

“…Robot assistance allowed for the execution of complex procedures with greater precision, confidence, and better results. This has enabled urologists to adapt to the whole spectrum of laparoscopic procedures to their field [32].…”