From buccal mucosa to appendix: a bibliometric and evidence-maturity analysis of autologous tissue-based robot-assisted ureteral reconstruction

Robot-assisted ureteral reconstruction has evolved from bowel substitution to free oral mucosal grafts and vascularized appendiceal techniques, yet the intellectual structure and clinical maturity of these autologous tissue strategies remain unclear. PubMed and the Web of Science Core Collection were searched from inception through 2 August 2026. Records were merged, deduplicated, screened, and linked to OpenAlex for bibliometric enrichment. Publication trends, institutional contributions, co-citation patterns, thematic evolution, evidence maturity, and outcome reporting were assessed. Among 201 unique records screened, 74 publications were included in the bibliometric corpus and 66 primary clinical or technical reports formed the evidence-maturity subset. Bowel segments were the largest category (28/74), followed by buccal mucosa (22/74), appendix (12/74), lingual/labial mucosa (11/74), and mixed tissue (1/74). Thirty-six publications appeared during 2024-2026, and co-citation analysis identified distinct mucosal-graft and bowel-substitution foundations. Of the 66 primary reports, 24 were classified as E1, 8 as E2, 10 as E3, 22 as E4, and 2 as E5. Outcome reporting remained heterogeneous, device-free status was not explicitly detectable, while patient-reported outcomes appeared in only 4-17% of reports across the principal tissue groups. Overall, the field is progressing from technical feasibility toward multicenter validation, but evidence maturity remains uneven. Buccal mucosa currently has the broadest robotic evidence base, lingual/labial grafting is expanding, appendiceal reconstruction remains an anatomy-dependent option, and bowel substitution continues to serve extensive defects. Future research should prioritize prospective comparisons, standardized core outcomes, and long-term functional and patient-reported follow-up.