Robot-assisted laparoscopic dismembered pyeloplasty: A combined experience

Michael A. Palese, Michael D. Stifelman, Ravi Munver, R. Ernest Sosa, Courtney K. Philipps, Caner Dinlenc, Joseph J. Del Pizzo

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

Background and Purpose: The need for advanced laparoscopic skills limits the implementation of laparoscopic pyeloplasty to centers with extensive experience. The introduction of robotic technology into the field of minimally invasive surgery has facilitated complex surgical dissection and genitourinary reconstruction. We report our experience with robot-assisted laparoscopic pyeloplasty using the daVinci™ Surgical System at three New York City medical centers. Patients and Methods: A retrospective review of all robot-assisted laparoscopic Anderson-Hynes dismembered pyeloplasty cases in 18 female and 17 male patients between April 2001 and January 2004 was performed. The average patient age was 39.0 years (range 15-69 years). All patients had symptoms or radiographic evidence of ureteropelvic junction (UPJ) obstruction. Robotic assistance with the daVinci surgical system was employed after preparation of the UPJ with a standard laparoscopic approach. Results: The mean operative time and suturing time was 216.4 ± 52.9 minutes and 63.0 ± 14.2 minutes, respectively. The average estimated blood loss was minimal at 73.9 ± 58.3 mL. The mean length of hospitalisation was 69.4 hours (range 28-310 hours). The average use of intravenous morphine was 28.4 mg (range 0-162 mg). There were no intraoperative complications or open conversions. A mean follow-up of 7.9 months revealed a success rate of 94%, with two patients requiring further treatment. Conclusions: This combined multi-institutional series reveals that robot-assisted pyeloplasty with the daVinci surgical system is safe and reproducible. These intermediate results appear comparable to those of open and laparoscopic pyeloplasty repairs.

Original languageEnglish
Pages (from-to)382-386
Number of pages5
JournalJournal of Endourology
Volume19
Issue number3
DOIs
StatePublished - Apr 2005
Externally publishedYes

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