Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults

Abstract

ObjectiveTo present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults.Patients and methodsWe 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.ResultsThe 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.ConclusionThe 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.

Robot-assisted ureteric reconstructive surgeries for benign diseases: Initial single-center experience with point of technique

“…The mean operative timings of various surgeries of reconstructive urology in our study where Da Vinci Xi was used were comparable or lesser than the timings of similar surgeries done in other robotic surgical series where Da Vinci Si systems were used (Table 4). 20–24 This can be attributed to following advantages of Da Vinci Xi over Da Vinci Si robotic system 6,25 :…”

Pediatric robotic‐assisted laparoscopic ureterocalycostomy: Salient tips and technical modifications for optimal repair

“…Ureterocalycostomy is useful in patients with extensive peripelvic scarring, allowing for dependent drainage, and may compensate for lack of adequate ureteral length. Laparoscopic and robotic‐assisted laparoscopic ureterocalycostomy has a good track record of success in the adult literature 1–5 . As this procedure is infrequently performed, there is a paucity of literature regarding robotic ureterocalycostomy in the pediatric population 6,7 .…”

“…Laparoscopic and robotic‐assisted laparoscopic ureterocalycostomy has a good track record of success in the adult literature. 1 , 2 , 3 , 4 , 5 As this procedure is infrequently performed, there is a paucity of literature regarding robotic ureterocalycostomy in the pediatric population. 6 , 7 We report our experience with robotic ureterocalycostomy of a single surgeon and describe salient tips for successful repair, especially in patients with ample renal cortex where identification of a dependent cortex may be difficult and bleeding may occur during lower pole nephrectomy.…”