Robotic dismembered pyeloplasty: a 6-year, multi-institutional experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic surgery offers advantages in complex reconstructive procedures.
• Robotic dismembered pyeloplasty addresses technical challenges in laparoscopic repair of ureteropelvic junction obstruction.

Purpose of the Study:

• To review a large, multi-institutional experience with robotic dismembered pyeloplasty.
• To evaluate the long-term efficacy and safety of robotic pyeloplasty for ureteropelvic junction obstruction.

Main Methods:

• Retrospective chart review of 140 patients undergoing robotic dismembered pyeloplasty across 3 university medical centers.
• Data collected included demographic, preoperative, operative, and postoperative parameters.
• Patients were analyzed as a cohort and in subgroups based on repair type and comorbidities.

Main Results:

• Successful repair in 95.7% of patients based on postoperative imaging.
• High rates of primary repair (84.6%) and management of complex cases including solitary kidneys and crossing vessels (55%).
• Low complication rates (7.1% major, 2.9% minor) with a mean follow-up of 29 months.

Conclusions:

• Robotic dismembered pyeloplasty is a safe, durable, and effective option for primary and secondary ureteropelvic junction obstruction.
• The procedure demonstrates efficacy even in patients with solitary kidneys or requiring concomitant stone extraction.
• This multi-institutional review represents a significant contribution to understanding long-term outcomes in robotic pyeloplasty.