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Updated: Mar 2, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
[Robot-assisted and laparoscopic pyeloplasty.]
Juan Ignacio Pascual-Piédrola1, Imanol Merino-Narro1, Mateo Hevia-Suárez1
1Departamento de Urología. Clínica Universidad de Navarra. Pamplona. España.
Insights
Minimally invasive surgery, including laparoscopic and robotic pyeloplasty, offers comparable success rates to open surgery for uretero-pelvic junction obstruction. Laparoscopic techniques are recommended for adults due to shorter hospital stays.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Pediatric Surgery
Background:
- Uretero-pelvic junction (UPJ) obstruction traditionally treated with open dismembered pyeloplasty.
- Laparoscopic pyeloplasty (LP) and robotic pyeloplasty (RP) are increasingly preferred for UPJ stenosis in adults and children.
Purpose of the Study:
- To review minimally invasive surgery outcomes for UPJ obstruction.
- To analyze trends and limitations of LP and RP.
Main Methods:
- Systematic review of relevant papers and meta-analyses on LP and RP.
- PubMed database search for pediatric and adult UPJ obstruction studies.
Main Results:
- Pediatric: LP, RP, and open surgery show similar success rates, complication rates, and hospital stays. Open surgery has shorter operating times and remains the choice for young children.
- Adults: LP and RP demonstrate comparable success and complication rates. Minimally invasive approaches offer reduced hospital stay and analgesic requirements, favoring their use over open surgery.
Conclusions:
- Minimally invasive surgery is considered the standard treatment for UPJ stenosis, with outcomes comparable to open surgery.
- The high cost of robotic surgery restricts its application in UPJ obstruction treatment.
Objectives:
Uretero-pelvic junction (UPJ) obstruction has been classically treated by open dismembered pyeloplasty. Recently, laparoscopic (LP) and robotic pyeloplasty (RP) have become the techniques of choice for the treatment of UPJ stenosis in adult and pediatric population. Our objective in this paper is to review the results of minimally invasive surgery as the treatment of UPJ obstruction, the trend to use these approaches and the current limits of LP and RP.
Methods:
A review of most relevant papers and meta-analysis about LP and RP in pediatric and adult population was performed using PubMed.
Results:
In pediatric population, comparative studies and meta-analysis of relevant series show an overlap of results between LP, RP and open surgery in terms of success rate, rate of complications and hospital stay, being operating time shorter in open pyeloplasty compared to minimally invasive techniques. In infants and pre-school age open surgery remains as technique of choice for pediatric surgeons. In adults, comparative studies and meta-analysis of the most relevant series show also an overlap of results in terms of success rate and complication rate between LP and RP. Nonetheless, minimally invasive techniques seem to offer a significant shortening of hospital stay and need for analgesics compared to open surgery, reason why laparoscopic techniques are recommended over open pyeloplasty in adult population.
Conclusions:
In view of published literature, minimally invasive surgery has been postulated as the standard treatment in UPJ stenosis, with superimposable results to open surgery. The high cost of robotic approach limits its use in this type of pathology.
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