Robotic-assisted Proximal Perineal Urethroplasty: Improving Visualization and Ergonomics

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Posterior urethral stricture repair demands deep dissection, complicating suture placement and visualization.
• Robotic platforms offer enhanced dexterity and optics beneficial for deep pelvic procedures.

Purpose of the Study:

• To evaluate the utility of robotic assistance for proximal suture placement in perineal urethroplasty.
• To assess the feasibility and outcomes of robotic-assisted urethroplasty for posterior and proximal bulbar urethral strictures.

Main Methods:

• Retrospective review of 10 patients undergoing robotic-assisted urethroplasty by a single surgeon.
• Standard perineal dissection followed by robotic-assisted proximal suture placement.
• Outcomes assessed included leak rates, success rates, and complications.

Main Results:

• No urinary extravasation observed on postoperative voiding cystourethrograms.
• Robotic setup averaged 15 minutes, with suture placement taking 30-45 minutes.
• Operative and postoperative outcomes were comparable to standard approaches.

Conclusions:

• Robotic-assisted urethroplasty offers superior visualization and ergonomics for urethral reconstruction.
• This approach is particularly advantageous for narrow pelvic anatomy and challenging proximal repairs.
• Outcomes appear comparable to open surgery, with enhanced surgeon comfort.