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Related Experiment Video

Updated: May 1, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
03:57

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

Published on: July 8, 2025

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Robotic laparoscopic pyeloplasty.

Mario F Chammas1, Anuar I Mitre2, Nicolas Hubert3

  • 1Division of Urology, University of São Paulo School of Medicine, São Paulo, Brazil. mariochammas@usp.br.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|April 1, 2014
PubMed
Summary
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Robotic pyeloplasty is a feasible and effective treatment for ureteropelvic junction obstruction, including complex cases. This minimally invasive approach demonstrates consistent success rates, even with atypical anatomy or prior treatments.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Ureteropelvic junction (UPJ) obstruction is a common cause of hydronephrosis.
  • Robotic-assisted laparoscopic pyeloplasty offers a minimally invasive alternative to open surgery.
  • Complex UPJ obstruction cases, including those with atypical anatomy or prior interventions, present unique challenges.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in complex UPJ obstruction cases.
  • To compare the results of robotic pyeloplasty in primary versus complex UPJ obstruction.
  • To identify potential complications and success rates in challenging UPJ obstruction scenarios.

Main Methods:

  • Retrospective review of 131 consecutive robotic-assisted laparoscopic pyeloplasty cases.

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  • Categorization into primary (Group 1) and complex (Group 2) UPJ obstruction cases (17 complex cases).
  • Complex cases included atypical anatomy (e.g., horseshoe kidneys) or previous UPJ obstruction management.

    • Main Results:

    • Operative time was longer in complex cases (153.5 min) compared to primary cases (117.3 min).
    • Hospital stay and success rates at 3 months and 1 year were comparable between groups (93% vs 88.2% at 3 months).
    • One complex case required secondary procedure due to a colon injury; no major complications in primary cases.

    Conclusions:

    • Robotic pyeloplasty is a feasible and effective treatment for UPJ obstruction, including complex presentations.
    • Consistent success rates are achievable even in cases with atypical anatomy or prior UPJ obstruction management.
    • Caution is advised during colon dissection in patients with a history of colonic pathology.