Abstract
Uretero-pelvic junction obstruction (UPJO) leads to impaired transport of urine from the renal pelvis to the ureter and might lead to deterioration of renal function. Congenital causes, acquired factors and presence of an aberrant crossing vessel are the etiologic factors. Surgical correction is applied in the treatment of UPJO. Minimally invasive approaches including laparoscopic and robotic approaches are increasingly being performed. Robotic pyeloplasty is most frequently applied transperitoneally. The outcomes of robotic (transperitoneal and retroperitoneal), laparoscopic and open pyeloplasties seem to be similar due to the published literature. Robotic approach has the advantages of enabling quicker tissue dissection, reconstruction, intracorporeal suturing, antegrade double-J stenting and better ergonomics for the console surgeon. Although cost is an issue for robotic surgery, being a minimally invasive surgical approach with excellent functional and surgical outcomes are the advantages in addition to better cosmetic results for the patient. In this paper, surgical technique of robotic pyeloplasty is explained and outcomes of this approach are summarized by reviewing the literature.
Highlights
Uretero-pelvic junction (UPJ) obstruction leads to impaired transport of urine from the renal pelvis to the ureter that might cause increased pressure in the renal pelvis and deterioration of renal function
Invasive pyeloplasty including robotic and laparoscopic approaches were reported to have lower morbidity, shorter duration of hospital stay, and less blood loss compared with open surgical approach [4]
Outcomes of both laparoscopic and robotic pyeloplasty approaches were reported to have durable with similar success rates in long term
Summary
Uretero-pelvic junction (UPJ) obstruction leads to impaired transport of urine from the renal pelvis to the ureter that might cause increased pressure in the renal pelvis and deterioration of renal function. It has been reported that, laparoscopic, retroperitoneoscopic and robotic approaches have similar success rates compared to open surgical approach in experienced centers [3]. A 10 mm sized assistant port is inserted into to abdominal cavity approximately located 4-5 cm lateral to the camera port for introducing sutures, suction, JJ stent and removing tissue cut portions. Ureter is dissected up to the renal pelvis (Figure 4a-c).
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