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Robotic-assisted laparoscopic pyeloplasty: initial Australasian experience.

Rohan Matthew Hall1,2, Declan G Murphy3,4, Ben Challacombe3,4

  • 1Departments of Urology, Epworth Hospital, Richmond, VIC, Australia. rohanhall@ausdoctors.net.

Journal of Robotic Surgery
|September 16, 2016
PubMed
Summary

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Robotic-assisted laparoscopic pyeloplasty (RALPY) offers a safe and effective solution for uretero-pelvic junction obstruction. This technique simplifies complex suturing, potentially reducing operative times and improving outcomes for patients.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Uretero-pelvic junction (UPJ) obstruction is commonly treated with laparoscopic pyeloplasty.
  • Laparoscopic intracorporeal suturing presents technical challenges and can increase operative duration.
  • Robotic assistance may overcome these laparoscopic suturing difficulties.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of trans-peritoneal robotic-assisted laparoscopic pyeloplasty (RALPY) for UPJ obstruction.
  • To assess the impact of robotic assistance on operative time and complexity of suturing.

Main Methods:

  • Prospective data collection on peri-operative and outcome metrics for 24 adult patients undergoing RALPY.
  • Utilized the da Vinci surgical system for intracorporeal suturing, with increasing integration of robotic assistance throughout the series.
Keywords:
LaparoscopicPyeloplastyRobotic-assistedTechniqueUreteropelvic junction obstructionda Vinci

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  • Follow-up included diuretic renography at 6 months to assess renal drainage.

    • Main Results:

    • Mean operative time was 211 minutes, with a mean anastomotic time of 44 minutes.
    • Mean estimated blood loss was 56 ml, with one temporary urine leak.
    • All patients demonstrated satisfactory renal drainage post-surgery, with a median hospital stay of 4 days.

    Conclusions:

    • Robotic-assisted laparoscopic pyeloplasty (RALPY) is a safe and feasible surgical option for UPJ obstruction.
    • This technology can simplify complex laparoscopic suturing, potentially leading to shorter operative times and excellent patient outcomes.
    • RALPY is now the preferred surgical approach for UPJ obstruction at the institution.