Transmesocolic robot-assisted pyeloplasty: single center experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Ureteropelvic junction obstruction (UPJO) is a common cause of pediatric and adult kidney disease.
• Traditional open pyeloplasty can involve significant patient morbidity.
• Robotic-assisted pyeloplasty offers potential advantages in terms of precision and recovery.

Purpose of the Study:

• To evaluate the technical feasibility and outcomes of the transmesocolic approach for robotic pyeloplasty in patients with left UPJO.
• To assess the safety and efficacy of this specific surgical technique.

Main Methods:

• A retrospective review of 60 robot-assisted pyeloplasty cases was conducted.
• The transmesocolic approach was utilized in 24 of 27 left-sided UPJO cases.
• All procedures involved a pure robot-assisted dismembered reduction pyeloplasty.

Main Results:

• The mean operative time was 125.33 minutes with an average blood loss of 38.7 mL.
• Average hospital stay was 2.5 days, with drains removed within 48 hours in most cases.
• No patient showed clinical or radiographic evidence of recurrent obstruction after a 1-year follow-up.

Conclusions:

• The transmesocolic approach is a safe and feasible technique for robotic pyeloplasty in select patients with left UPJO.
• This method avoids extensive colon mobilization and allows direct access to the UPJO.
• The technique demonstrates high effectiveness and durable success rates similar to open surgery.