Robot-assisted laparoscopic Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction

To explore surgical, functional, and symptomatic outcomes in a series of patients who underwent robot-assisted laparoscopic Anderson-Hynes pyeloplasty (RALP) for ureteropelvic junction obstruction using the DaVinci Si surgical robotic system.

Retrospective study including patients aged 16 years or older who underwent RALP from June 2016 to December2021. The following outcomes were recorded: operative outcome and complications [classified according to the Clavien-Dindo Classification (CD)] within 30 days of the procedure as well as 1 year success rate and restenosis during follow-up.

In total, 194 patients were available for analyses with a median follow-up of 4.5 (IQR 3.0-6.0) years. The primary indications were loss of kidney function (45%), pain (36%), infection (11%), kidney stone (6%), and others (2%). The median operation time was 134 min (IQR 112-159), the median length of stay was 2 days (IQR 2-2), and the median time with double-j stent postoperatively was 24 days (IQR 22-27). Overall, 65 out of 194 patients (33%) experienced a postoperative complication (12% CD I, 13% CD II, 8% CD IIIa or IIIb). The 1 year success rate was 92% for patients treated because of deteriorating renal function, 78% for patients treated because of symptoms, 82% for patients treated because of infections, and 78% for patients treated because of kidney stones. Seven percent of the patients presented a recurrent ureteropelvic junction stricture during follow-up.

In our experience, robot-assisted laparoscopic Anderson-Hynes pyeloplasty performed with the DaVinci Si system is a safe with a few major complications and acceptable success rate.