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Updated: Apr 26, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Robot assisted laparoscopic pyeloplasty in obese and non-obese patients
Bruce W Lindgren1, Brendan T Frainey1, Earl Y Cheng1
1Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Insights
Robot-assisted laparoscopic pyeloplasty (RALP) is safe and effective for children across all weight categories. Increased BMI did not negatively impact surgical outcomes or complication rates in this study.
Area of Science:
- Pediatric Surgery
- Urology
- Robotic Surgery
Background:
- Robot-assisted laparoscopic pyeloplasty (RALP) is a common procedure for pediatric ureteropelvic junction obstruction.
- The impact of increased body mass index (BMI) on surgical outcomes in children is not well-established.
Purpose of the Study:
- To evaluate the safety and efficacy of RALP in children with varying BMI percentiles.
- To determine if elevated BMI negatively affects surgical outcomes or complication rates.
Main Methods:
- Retrospective review of 103 patients who underwent RALP.
- Patients were stratified into healthy weight, overweight, and obese groups based on age-adjusted BMI percentile.
- Surgical and postsurgical outcomes, including operative time, estimated blood loss, length of stay, narcotic administration, complication rates, and reoperation rates, were analyzed.
Main Results:
- No significant differences were observed in operative time, estimated blood loss, length of stay, or narcotic administration between the weight groups.
- Complication rates (minor and major) and the rate of decreased hydronephrosis were similar across all BMI cohorts.
- Only 3.4% of patients required reoperation, with no significant difference based on BMI.
Conclusions:
- RALP can be performed safely and effectively in overweight and obese children.
- Increased BMI does not appear to be a significant negative factor for RALP outcomes in pediatric patients.
- These findings support the use of RALP regardless of a child's weight status.
Objective:
We assessed whether increased BMI has a negative impact in children undergoing robot assisted laparoscopic pyeloplasty (RALP).
Patients And Methods:
Records of patients who underwent RALP were retrospectively reviewed and separated into healthy weight, overweight, and obese cohorts based on age-adjusted BMI percentile, and surgical and postsurgical outcomes were evaluated.
Results:
Of the 103 patients, there were 79 healthy weight and 24 overweight, with 10 of the 24 considered obese (BMI<85th, ≥85th, and ≥95th percentile for age, respectively). Cohorts were similar in respect to age, sex, laterality and symptoms. Operative time (234 min, 241 min, p=0.642; 254 min, p=0.324), EBL (7.1 ml, 10.5 ml, p=0.293; 6.8 ml, p=0.906), length of stay (1.2d, 1.2d p=0.545; 1.1d p=0.550), and narcotic administration (0.25 mg/kg, 0.25 mg/kg, p=0.545; 0.13 mg/kg, p=0.430) were similar between healthy weight, overweight, and obese cohorts, respectively. Complication rates were similar in regard to minor and major complications. There was no difference in decreased hydronephrosis (92.2%, 89.6%, p=0.440; 88.9%, p=0.730). Four patients (3.4%) required a reoperative procedure (three healthy weight, one overweight; p=NS).
Conclusions:
Despite the potential difficulties with surgery in overweight patients, our data indicate that robot-assisted laparoscopic pyeloplasty can be performed as safely and effectively in overweight or obese children as in healthy weight children.
