Global landscape of robot-assisted complex ureteral reconstruction: a bibliometric and knowledge-mapping analysis

Complex ureteral reconstruction is technically demanding. Traditional open and laparoscopic approaches entail significant trauma, limited visibility, and poor dexterity. Robot-assisted systems, with three-dimensional high-definition (3D HD) vision, multi-degree-of-freedom(DOF)instruments, and precise suturing capabilities, can reduce the technical difficulty and improve outcomes to some extent. Although research output has grown rapidly, a comprehensive bibliometric analysis of the overall landscape, collaboration networks, and trends is lacking. This study visualizes the global knowledge base and research frontiers of robot-assisted complex ureteral reconstruction (RACUR). We searched the Web of Science Core Collection (WoSCC) from inception through July 1, 2026, for English-language articles and reviews addressing RACUR. The revised search and final data export were completed on July 18, 2026. After Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-based screening, 312 publications (272 articles and 40 reviews) were included. VOSviewer, CiteSpace, Scimago Graphica, Microsoft Excel, and R were used to analyze publication and citation trends, collaboration networks, journals, co-cited references, keywords, source concentration, author productivity and reconstructive techniques. The corpus had received 4,441 citations (mean, 14.23 per publication; h-index, 35). Annual output reached 48 publications in 2025; 29 additional publications were identified through July 1, 2026. Under full counting, the USA contributed the most publications (n = 153), whereas Italy had the highest country-level total link strength (43). The evidence portfolio was dominated by retrospective case series (151, 48.4%) and retrospective comparative cohorts (60, 19.2%). Among original articles, the leading primary techniques were direct ureteral reimplantation (74), ureteroureterostomy (41), oral mucosa graft ureteroplasty (32), Boari flap/psoas hitch reimplantation (23), and ileal ureter replacement (22). Of the 272 articles, 165 (60.7%) were published during 2021-2026. Keyword and burst patterns suggested an interpretive transition from feasibility and reimplantation-oriented work toward image guidance, graft or substitution techniques, and complex stricture reconstruction. RACUR research has expanded substantially but remains geographically concentrated and methodologically limited by predominantly retrospective evidence. Future multicenter prospective studies, standardized outcome definitions, health-economic evaluations, and independent assessment of emerging robotic platforms are needed to clarify the appropriate role of RACUR across clinical indications.