<p>Comparison of Safety, Efficacy and Outcomes of Robot Assisted Laparoscopic Pyeloplasty vs Conventional Laparoscopy</p>

Abstract

Pyeloplasty is considered the gold standard for the management of ureteropelvic junction obstruction in cases of flank pain, recurrent stone formation or infection, and deteriorating renal function. Over the last two decades, minimally invasive techniques such as robotic (RALP) and laparoscopic pyeloplasty (LP) have become increasingly popular and have been moderately replacing the open approach. This paper aims to provide a comprehensive up-to-date review on safety, efficacy and outcomes regarding robotic repair of UPJO compared to the conventional laparoscopic procedure. RALP represents a viable and innovative alternative to conventional LP with a comparable success and complication rate both in adult and in paediatric fields. The robotic approach seems to add further technical advantages when compared to conventional LP but sustains a higher costs. Currently, the choice to adopt one of the different minimally invasive approaches depends on the surgeon’s preference or experience, and on institutional availability.

The Impact of Preoperative Double-J Stent on Perioperative Complications, Recurrence, and Quality of Life in Adult Patients Undergoing Pyeloplasty

“…Relative to other previous publications, overall complications rates of the current study are slightly higher than in cohorts that exclusively relied on pyeloplasties performed with laparoscopic or robotic approaches [4, 19]. However, in the current cohort, over 21% of all patients who underwent open pyeloplasty and also redo pyeloplasties were included, which are known risk factors for higher complication rates [7, 9, 10]. Compared to the study by Lee et al [15], Clavien-Dindo complications ≥3 were comparable between patients with and without preoperative DJ (5.0 vs. 3.7%), prior to ureteral reconstruction.…”

“…Pyeloplasties are the gold standard in the surgical management of (symptomatic) ureteropelvic junction obstructions (UPJO) [1][2][3][4]. Pyeloplasties can usually be performed with either laparoscopic, robotic, or open ap- proaches, and success rates of pyeloplasties range between 61 and 100% and can achieve sufficient quality of life (QoL) of symptomatic patients [5][6][7][8][9][10][11]. Prior to pyeloplasty, symptomatic patients often receive a urinary drainage with double-J (DJ) stent to reduce UPJO-induced pain, minimize risk of acute urinary infection/pyelonephritis/urosepsis, and ensure kidney function.…”

Robotics in Australian urology contemporary practice and future perspectives

“…These urological operations have been performed robotically with safety and efficacy. There is a potential advantage in robotic pyeloplasty over laparoscopic pyeloplasty in the ability to perform reconstruction of the renal pelvis with much greater dexterity using robotic instrumentation than that with laparoscopic instrumentation 30 . Robotic pyeloplasty is now the preferred method of performing this surgery in centres with a robot platform.…”

Robotic versus Open Pyeloplasty: Perioperative and Functional Outcomes

“…The robotic surgical platform is a valid surgical alternative in UPJO treatment, offering well-known advantages such as 3D visualization, magnification of the operative field, improved dexterity and ergonomics, and motion scaling with tremor reduction systems that facilitate dissection and intracorporeal suturing [ 11 ]. In addition, perioperative morbidity seems to be lower, and the learning curve is shorter than laparoscopic pyeloplasty [ 12 ].…”