1219 ROBOT-ASSISTED LAPAROSCOPIC PYELOPLASTY: OUTCOMES FROM A SINGLE-INSTITUTION STUDY

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy1 Apr 20111219 ROBOT-ASSISTED LAPAROSCOPIC PYELOPLASTY: OUTCOMES FROM A SINGLE-INSTITUTION STUDY Scott Tobis, Sriram Venigalla, Dragan Golijanin, Hani Rashid, Jean Joseph, and Guan Wu Scott TobisScott Tobis Rochester, NY More articles by this author , Sriram VenigallaSriram Venigalla Rochester, NY More articles by this author , Dragan GolijaninDragan Golijanin Rochester, NY More articles by this author , Hani RashidHani Rashid Rochester, NY More articles by this author , Jean JosephJean Joseph Rochester, NY More articles by this author , and Guan WuGuan Wu Rochester, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.875AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Minimally invasive pyeloplasty has become the gold standard for the treatment of uteropelvic junction obstruction (UPJO) in the adolescent and adult populations. Robot-assisted laparoscopic pyeloplasty (RAP) has become the preferred method of treatment for ureteropelvic junction obstruction (UPJO) at our institution. Currently published series of RAP include primarily aggregated data from smaller series at multiple institutions. To our knowledge this represents the largest single-center experience to date. METHODS Patient demographics, perioperative parameters, and outcomes of RAP procedures performed between September 2004 and June 2010 were retrospectively reviewed under an institutional review board approved protocol. All operations were performed by one of three surgeons (JJ, HR, GW) using the da Vinci S or Si Surgical System. RESULTS One hundred patients (64 female and 36 male) underwent RAP during the study time frame. The median age at surgery was 38.5 years (range, 11–84), and the median body mass index was 25.8 kg/m2 (18.8–46.9). Etiology of UPJO included a crossing vessel in 57 patients, stenotic ureteropelvic junction in 28, and high insertion of the ureter in 20. Twelve cases involved RAP of a recurrent UPJO from prior repair (5 open, 7 endopyelotomy). Median operative time and estimated blood loss were 189 minutes (109–446) and 50 mL (5–250), respectively. Ureteral stents were left in place in all but one patient, and closed suction drains were placed in 60 patients. Median length of stay was 2 days (1–6), and median length of follow up was 6 months (1–47). Median change in glomerular filtration rate was 0.0 mL/min/1.73 m2. One major perioperative complication was observed, which was a urine leak that resolved with prolonged drainage. There were seven minor complications. There were 2 failures noted during the study time frame. One patient had evidence of continued obstruction, eventually requiring laparoscopic nephrectomy for recurrent infections and poor renal function. The second patient has demonstrated diminishing renal function but remains asymptomatic. CONCLUSIONS Robot-assisted laparoscopic pyeloplasty (RAP) is a safe and effective method of UPJO repair. Short-term outcomes are excellent and perioperative complications are low. Recurrences from prior repair attempts can also be successfully managed with RAP. Longitudinal studies are necessary to determine the long-term recurrence rate. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e489 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Tobis Rochester, NY More articles by this author Sriram Venigalla Rochester, NY More articles by this author Dragan Golijanin Rochester, NY More articles by this author Hani Rashid Rochester, NY More articles by this author Jean Joseph Rochester, NY More articles by this author Guan Wu Rochester, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...