Balancing technology and resources: Is robotic pyeloplasty always necessary?

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Ureteropelvic junction obstruction (UPJO) impairs renal function by blocking urine flow.
• Treatment aims to relieve obstruction and preserve kidney function.
• Robotic-assisted laparoscopic pyeloplasty (RALP) may offer advantages over traditional laparoscopic pyeloplasty (LP).

Purpose of the Study:

• To compare the outcomes of RALP and LP in adult patients with UPJO.
• To evaluate operative time, blood loss, complication rates, and success rates between the two surgical techniques.

Main Methods:

• Retrospective cohort analysis of 128 adult patients undergoing RALP or LP.
• Data collected on operative time, estimated blood loss (EBL), hospital length of stay (LOS), complications, and success.
• Statistical analysis using Mann-Whitney, chi-squared, and Fisher's exact tests (p <0.05).

Main Results:

• RALP had significantly longer operative times (200.92 min vs 161.92 min, p <0.001) due to robotic docking.
• EBL and success rates were similar between RALP (97.7%) and LP (97.4%).
• RALP patients had a longer LOS (3.91 days vs 3.41 days, p = 0.001).

Conclusions:

• RALP offers technical benefits but does not decrease operative time and increases resource utilization compared to LP.
• Both RALP and LP achieve high success rates for UPJO treatment.
• Further research is needed on RALP's cost-effectiveness in UPJO management.