Outcomes of robotic‐assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients

Abstract

ObjectiveTo evaluate the long-term outcomes of robotic-assisted laparoscopic (RAL) upper urinary tract (UUT) reconstruction performed at a tertiary referral centre. Materials and MethodsData from 250 consecutive patients undergoing RAL UUT reconstruction, including pyeloplasty with or without stone extraction, ureterolysis, uretero-ureterostomy, ureterocalicostomy, ureteropyelostomy, ureteric reimplantation and buccal mucosa graft ureteroplasty, were collected at a tertiary referral centre between March 2003 and December 2013. The primary outcomes were symptomatic and radiographic improvement of obstruction and complication rate. The mean follow-up was 17.1 months. ResultsRadiographic and symptomatic success rates ranged from 85% to 100% for each procedure, with a 98% radiographic success rate and 97% symptomatic success rate for the entire series. There were a total of 34 complications, none greater than Clavien grade 3. ConclusionRobotic-assisted laparoscopic UUT can be performed with few complications, with durable long-term success, and is a reasonable alternative to the open procedure in experienced robotic surgeons.

Laparoscopic ureterocalicostomy for ureteropelvic junction obstruction in a 10-year-old female patient: a case report

“…For this purpose, mobilization of the ureter while preserving vascular supply and a reliable suturing technique are essential. Recently, robotic-assisted laparoscopic UC has been reported [13, 14]. The advantages of robotics are three-dimensional visualization and increased freedom of movement compared to conventional laparoscopy.…”

Delayed Recognition of an Ureteropelvic Junction Obstruction in a Young Adult Female

“…In recent years minimally invasive approaches have emerged as a viable alternative with decreased pain, earlier convalescence, shorter hospital stay, and improved cosmetics. Recent studies of robotic pyeloplasty in both children and adults have produced low complication rates with long-term efficacy equivalent to an open approach [ 8 , 9 ]. We perform retrograde pyelogram at the time of surgery to localize the site of obstruction for robotic port placement.…”

Robotic buccal mucosa graft ureteroplasty (inlay and onlay) for upper ureteric stricture: Point of technique

“…Minimally invasive buccal mucosal graft (BMG) ureteroplasty can be performed in such cases using robotic platform. [ 1 2 3 ] Principle of surgery remains the same as in any other reconstruction, that is creation of water-tight, tension-free and well-vascularised anastomosis. Robotic platform allows the urologist to perform these steps successfully through magnified view, three-dimensional field of vision, with increased dexterity and the ability to precisely place sutures using EndoWrist technology.…”

“…[ 7 8 ] There are a few case reports in which the robotic platform is used for the treatment of complex ureteral strictures using the BMG as a tube or an onlay flap. [ 1 2 3 ] We describe the use of the BMG as onlay and inlay graft instead of the conventional onlay or tube in ureteral stricture reconstruction, using a robotic platform.…”