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Updated: Jul 13, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Comparison of clinical outcomes of robotic versus open pyeloplasty in infants under 6 months
Alexandra Bain1, Jacqueline Morin1, Amanda Sion2
1Department of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Robotic and open pyeloplasty offer similar surgical outcomes and hospital stays for infants under six months old. Robotic procedures had longer operative times but comparable success rates and complication profiles to open surgery.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Surgical Outcomes Research
Background:
- Ureteropelvic junction obstruction (UPJO) is commonly treated with pyeloplasty in children.
- Robotic pyeloplasty is increasingly popular, but its use in infants under six months is debated due to workspace limitations.
- Concerns exist regarding potential lack of benefit compared to open surgery in this age group.
Purpose of the Study:
- To compare peri-operative and post-operative outcomes of robotic versus open pyeloplasty in infants under six months of age.
- To evaluate surgical success and complication rates for both approaches in a pediatric population.
- To determine the viability of robotic pyeloplasty in very young infants.
Main Methods:
- Retrospective review of 32 patients (16 robotic, 16 open) under six months old undergoing pyeloplasty (2020-2024).
- Comparison of patient demographics, clinical outcomes, operative time, hospital stay, narcotic usage, and complication rates.
- Surgical success defined as >50% reduction in antero-pelvic diameter (APD) at one year post-procedure.
Main Results:
- No significant difference in hospital stay or narcotic usage between robotic and open pyeloplasty groups.
- Robotic pyeloplasty had a significantly longer operative time (209.5 min vs. 142.5 min, p < 0.001).
- No significant differences observed in post-operative complications or surgical success rates between the two surgical approaches.
Conclusions:
- Both robotic and open pyeloplasty are viable surgical options for infants under six months with UPJO.
- Equivalent surgical outcomes and hospital lengths of stay were observed for both methods in this cohort.
- Robotic pyeloplasty demonstrates comparable efficacy to open surgery in young infants, despite longer operative times.
Introduction:
Robotic pyeloplasties have become the popular approach for surgical repair of ureteropelvic junction obstruction (UPJO) in the pediatric population. In infants less than 6 months old, there is concern for lack of intra-abdominal working space and lack of benefit compared to an open approach. Our aim was to compare the peri-operative and post-operative outcomes of patients undergoing open versus robotic pyeloplasty under six months of age.
Methods:
A retrospective review was performed of patients less than six months of age undergoing robotic or open pyeloplasty between 2020 and 2024 at a single institution. Patient demographics and clinical outcomes were collected and compared. Surgical success was defined as a >50% reduction in the antero-pelvic diameter (APD) of the affected kidney at one year post pyeloplasty.
Results:
A total of 32 patients were identified (16 robotic and 16 open), median age at surgery was 4 months old. There was no significant difference in length of hospital stay or narcotic usage between the two groups. The robotic cohort had a significantly longer operative time (209.5 min vs 142.5 min, p < 0.001) compared to the open cohort. There was no significant difference between post-operative complication or surgical success rates between the two groups.
Conclusion:
In this small series, robotic and open pyeloplasty both remain viable options for infants less than 6 months of age with equivalent surgical outcomes and lengths of hospital stay.