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Current Status of Robotic-Assisted Pyeloplasty in Adults

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Robotic Urologic Surgery

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Abstract

The standard treatment of ureteropelvic junction obstruction (UPJO) is represented by the Anderson-Hynes dismembered pyeloplasty. Robot-assisted pyeloplasty (RP) is a feasible and safe approach to this condition. The indications for the robotic approach remain the same as those for the laparoscopic or open pyeloplasty. Every patients with symptomatic UPJO or with decreasing renal function in the presence of UPJO should undergo RP. Robot-assisted pyeloplasty has excellent success rates for relief of obstruction and very low peri- and postoperative morbidity. The robotic surgical technique maintains the advantages of laparoscopic surgery, providing a more precise manipulation and visualization and a faster learning curve. Comparative studies are reported to confront the different techniques. Minimally invasive redo pyeloplasty is obviously a more challenging procedure due to fibrosis and adhesions. The precise movements with the robotic assistance and the amplified vision provide higher precision, thus, a bloodless dissection, and a high-quality suture above all in complex patients. Newer techniques and indications such as the employment of buccal mucosal graft, the single port approach, and indocyanine green injection are described.

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Author information

Authors and Affiliations

  1. Department of Urology, Humanitas Clinical and Research Institute IRCCS, Rozzano, Italy

    Pietro Diana & Nicolomaria Buffi

  2. Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium

    Simone Scarcella & Geert De Naeyer

  3. Department of Urology, Polytechnic University of Marche Region, University Hospital “Ospedali Riuniti”, Ancona, Italy

    Simone Scarcella

  4. Department of Urology, Jackson Memorial Hospital, Miami, FL, USA

    Raymond J. Leveillee

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  1. Pietro Diana
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  2. Simone Scarcella
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  3. Raymond J. Leveillee
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  4. Geert De Naeyer
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  5. Nicolomaria Buffi
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Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA

    Peter Wiklund

  2. Department of Urology, ORSI Academy, Aalst, Belgium

    Alexandre Mottrie

  3. Pediatric Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

    Mohan S Gundeti

  4. Urology, Global Robotics Institute, Celebration, FL, USA

    Vipul Patel

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Diana, P., Scarcella, S., Leveillee, R.J., De Naeyer, G., Buffi, N. (2022). Current Status of Robotic-Assisted Pyeloplasty in Adults. In: Wiklund, P., Mottrie, A., Gundeti, M.S., Patel, V. (eds) Robotic Urologic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-00363-9_45

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  • DOI: https://doi.org/10.1007/978-3-031-00363-9_45

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  • Online ISBN: 978-3-031-00363-9

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