Outcomes of robot-assisted laparoscopic transperitoneal pyeloplasty procedures: a series of 18 patients

Abstract

OBJECTIVE: We evaluated outcomes of our robot-assisted laparoscopic transperitoneal pyeloplasty (RALP) procedures. MATERIAL AND METHODS: Between July 2011 and March 2014, 18 RALP procedures were performed at our instutition. Ureteropelvic junction obstruction (UPJO) diagnosis was made based on clinical presentation and intravenous urography. All patients underwent basal and diuretic isotopic renography to evaluate the degree of obstruction and impaired renal function. Anderson-Hynes dismembered pyeloplasty technique was used with a transperitoneal approach by using the da Vinci-S 4-arm surgical robot. Outcomes were assessed retrospectively. RESULTS: Mean patient age was 31.3±11.7 (13-62) years. Male: female ratio was 9: 9. All procedures were primary surgeries. Of 18 patients, 10 (55.5%) had a crossing vessel and 8 (44.5%) had intrinsic obstruction. Mean operative time was 150.4±17.2 (115-185) minutes. Mean anastomosis time was 21.4±5.5 (10-33) minutes. Mean blood loss during the operation was 33.6±17.3 (10-60) cc. Mean hospital stay was 2.6±1.0 (1-6) days. No conversion to open surgery was required. No intraoperative and perioperative (0-30 days) complication occurred. Readmission rate during perioperative period was 0%. Median follow-up was 16.6±10.3 (3-35) months. Postoperative intravenous urography and renography showed improved results in all cases. CONCLUSION: Due to our experience, RALP is a safe and feasible minimally invasive approach in patients with UPJO with excellent surgical and functional outcomes.