[Robot-assisted and laparoscopic pyeloplasty.]

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.