Purpose: Robot-assisted laparoscopic pyeloplasty (RALP) and laparoscopic pyeloplasty (LP) are both minimally invasive surgical options to correct ureteropelvic junction obstruction in children. There are limited data reporting surgeons' experience of switching from LP to RALP and comparing the outcomes of the two procedures.
Methods: We conducted a retrospective study on 63 consecutive children who underwent either LP or RALP by the same surgeon in a tertiary center from January 2008 to November 2016. LP had been the standard practice until January 2014 when it was replaced by RALP in short transition.
Results: Thirty-seven LP and 26 RALP were successfully performed in children aged 2 months to 16 years. There was no difference between the two groups in age, body weight, laterality, clinical presentations, preoperative imagings, primary/reoperative repairs. The overall success rates were 34/37 (91.9%) and 25/26 (96.2%) for LP and RALP, respectively (P > .05). RALP was associated with shorter length of stay (3.1 days versus 4.0 days; P = .03). Surgeon-in-training participation was greater in RALP group (P < .001). There was no difference in operative time, complication rates, and analgesic requirement between the two groups.
Conclusions: Surgeons proficient in LP can adapt quickly to RALP, achieving comparable outcomes. Robotic technology may facilitate training on minimally invasive pyeloplasty.
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http://dx.doi.org/10.1089/lap.2017.0561 | DOI Listing |
Radiol Case Rep
March 2025
Department of Surgery, Faculty of Medicine, October 6th University, Cairo, Egypt.
Most surgical procedures in the past were performed through large incisions. Advancement of laparoscopic surgery has led to smaller incisions and reduction in most of the incision-related complications. However, laparoscopic surgery has its own complications.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Urology, Persahabatan General Hospital, Jakarta, Indonesia. Electronic address:
Introduction: In adult patients, most ureteropelvic junction obstruction (UPJO) occurs secondarily. Concurrent UPJO with nephrolithiasis is not rare and simultaneous treatment by performing laparoscopic pyeloplasty and endoscopic stone removal has been suggested. In the case of atypical anatomy or previously failed pyeloplasty, a laparoscopic ureterocalicostomy is preferred.
View Article and Find Full Text PDFJ Robot Surg
January 2025
Department of Pediatric Anesthesia and Intensive Care, Necker-Enfants Malades University Hospital, AP-HP Centre, Université Paris Cité, 149, Rue de Sèvres 75015, Paris, France.
Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) is the commonest urologic procedure performed in children, entailing retroperitoneal CO2 insufflation and lateral decubitus, whose effects on cardiopulmonary variables are poorly known. We, therefore, studied hemodynamic and respiratory changes due to CO2 insufflation and lateral decubitus in children undergoing R-RALP and their effects on regional tissue oxygenation. Between 1/2021 and 7/2024, children affected by ureteropelvic joint obstruction (UPJO) underwent a pyeloplasty by R-RALP at Necker Enfants Malades Hospital (Paris, France), using a standardized surgical technique and a lung-protecting anesthetic protocol aimed to prevent hypercarbia.
View Article and Find Full Text PDFJ Pediatr Urol
December 2024
Departament of Urology, CACAU-NUPEP, São Paulo, Brazil. Electronic address:
Pyeloplasty at an early age (<2 years) can be treated by a flank open, laparoscopy or robotic approach. We want to demonstrate our strategy and how to construct a very inexpensive pyelostent from a Foley tube. The Ottoni catheter is made from a Foley tube, sectioning the proximal end keeping a plastic circular basement for fixation to the skin.
View Article and Find Full Text PDFAsian J Endosc Surg
December 2024
Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
A case of redo pyeloplasty using robot-assisted retroperitoneoscopic pyeloplasty (RARP) for failed primary laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) is reported. A 12-year-old boy had LP elsewhere. He was referred for management of persistent left hydronephrosis, but was managed conservatively due to minimal symptoms and stable radioisotopic renography.
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