Robot-assisted transperitoneal laparoscopic pyeloplasty

To describe the new technique of robot-assisted transperitoneal laparoscopic pyeloplasty for ureteropelvic junction (UPJ) stricture and to evaluate its clinical efficacy.Methods Of the 25 cases (18 men and 7 women) of UPJ stricture who underwent robot-assisted transperitoneal laparoscopic pyeloplasty,10 cases had severe hydronephrosis;10,intermediate;and 5 mild by B-ultrasound examination.Using intravenous urography (IVU) or CT urography (CTU),18 cases had good image;while 7 had poor image.Results The operation was successful in all the 24 cases with the operative time being 60-200 min (mean,90 min) and blood loss,40-80 ml.The mean hospital stay was 7 d (range,6-9 d).Follow-up of 3-32 months showed that lumbago disappeared in 25 cases and there was no stricture at UPJ by retrograde pyelography (RP).Hydronephrosis was remitted (among 10 cases with severe hydronephrosis,hydrops remitted from severe to intermediate in 8 and to mild in 2;among 10 cases with intermediate hydronephrosis,hydrops remitted from intermediate to mild in 3 and 7 had resolution;5 cases with mild hydronephrosis had resolution).IVU and CTU showed good image in 18 cases and improved image in 7.Conclusion Robot-assisted transperitoneal laparoscopic pyeloplasty is a more effective,more precise and minimally invasive surgical management for UPJ stricture.6 refs.