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Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
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Robotic versus Open Pyeloplasty: Perioperative and Functional Outcomes
Stefano Moretto1, Carlo Gandi1, Riccardo Bientinesi1
1Department of Urology, Università Cattolica del Sacro Cuore di Roma, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Journal of Clinical Medicine
|April 13, 2023
Summary
Robot-assisted laparoscopic pyeloplasty (RALP) shows comparable success rates to open pyeloplasty for ureteropelvic junction obstruction, with fewer complications but higher initial costs.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Health Economics
Background:
- Ureteropelvic junction obstruction is a common cause of pediatric and adult kidney issues.
- Pyeloplasty is the gold standard surgical repair.
- Robot-assisted laparoscopic pyeloplasty (RALP) offers potential benefits over traditional open pyeloplasty (OP).
Purpose of the Study:
- To compare surgical and economic outcomes of RALP versus OP for ureteropelvic junction obstruction.
- To evaluate the success rates, complication profiles, and direct costs of both procedures.
Main Methods:
- Retrospective study of 91 patients undergoing RALP or OP for ureteropelvic junction obstruction (2012-2022).
- Comparative analysis of preoperative, intraoperative, and postoperative outcomes, including success at 3 months and long-term follow-up.
- Economic assessment focused on direct costs per procedure and hospital stay.
Main Results:
- Similar 3-month success rates (93.0% RALP vs. 83.3% OP; p=0.178) and stable long-term results.
- RALP group demonstrated significantly lower intraoperative blood loss, need for postoperative analgesics and antibiotics, and fewer early complications.
- RALP incurred an average direct cost of 2373 € higher per procedure and hospital stay.
Conclusions:
- RALP is an effective and safe alternative for ureteropelvic junction obstruction repair.
- While RALP offers clinical advantages, its higher upfront cost necessitates further investigation into long-term cost-effectiveness, including indirect costs and platform advancements.
