How I do it: 3-Suture robotic pyeloplasty: Step-by-step technique.

Area of Science:

• Urology
• Pediatric Surgery
• Minimally Invasive Surgery

Background:

• Pediatric ureteropelvic junction obstruction is commonly treated with robot-assisted pyeloplasty.
• A standardized technique is crucial for consistent outcomes in robotic procedures.

Purpose of the Study:

• To describe and evaluate a standardized "3-suture" technique for robot-assisted pyeloplasty.
• To assess the efficacy and safety of this technique in pediatric patients.

Main Methods:

• A standardized "3-suture" technique was applied in 65 pediatric patients (aged 3-17 years).
• Data collected included operative time, complication rates (Clavien-Dindo grade III), and surgical success.
• Follow-up was conducted to assess long-term outcomes.

Main Results:

• The 3-suture technique resulted in a median operative time of 150 minutes.
• Major complications (Clavien-Dindo grade III) occurred in 4.6% of patients.
• Surgical success was achieved in 96% of cases at a median follow-up of 9.5 months.

Conclusions:

• The standardized 3-suture technique is a highly reproducible method for robot-assisted pyeloplasty.
• This approach facilitates accurate anatomical reconstruction and yields excellent surgical outcomes in pediatric patients.
• Robot-assisted pyeloplasty with this technique represents a gold standard for treating pediatric ureteropelvic junction obstruction.