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Updated: May 22, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
[Pyeloplasty - pro robotic-assisted]
1Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Kirrbergerstraße, 66421 Homburg, Deutschland.
Abstract:
Open pyeloplasty is still the gold standard in the treatment of ureteropelvic junction (UPJ) obstructions in many clinics. Similar functional results could be shown in diverse publications using conventional laparoscopic pyeloplasty (CLPP). The reconstruction of the UPJ is the main step during this type of surgery and constitutes a major challenge to surgeons working with minimally invasive techniques. The more complex the surgery the more obvious the benefits of robotic assistance (seven grades of freedom, 3D view etc.) in comparison to conventional laparoscopy. Thus robotic assistance is optimally suitable for pyeloplasty. The robotic-assisted laparoscopic pyeloplasty (RLPP) facilitates intracorporeal suturing and shortens the learning curve. Residents benefit from this shortened learning curve. Disorders caused by the non-physiological position during conventional laparoscopy are avoided during RLPP, which is an additionally benefit. Robotics also seem to be the optimum platform for the future of reconstructive LESS. The RLPP rather than the CLPP technique has therefore the potential to replace open pyeloplasty as the gold standard in treatment of UPJ.
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