Robotic Dismembered Pyeloplasty: A 6-Year, Multi-Institutional Experience

Patrick W. Mufarrij, Michael Woods, Ojas D. Shah, Michael A. Palese, Aaron D. Berger, Raju Thomas, Michael D. Stifelman

Research output: Contribution to journalArticlepeer-review

137 Scopus citations

Abstract

Purpose: The introduction of the da Vinci® Surgical System to perform complex reconstructive procedures, such as repair of ureteropelvic junction obstruction, has helped to overcome some of the technical challenges associated with laparoscopy. We review our large multi-institutional experience with long-term followup of robotic dismembered pyeloplasty. Materials and Methods: A total of 140 patients from 3 university medical centers underwent robotic dismembered pyeloplasty. An institutional review board approved retrospective chart review was performed to collect demographic, preoperative, operative and postoperative data. Patients were analyzed as an entire cohort and then divided into various subgroups. Results: Of the cases 117 (84.6%) were primary repairs and 23 (16.4%) were secondary repairs. There were 13 (9.3%) patients who underwent concomitant stone extraction and 5 (3.6%) procedures were performed on patients with solitary kidneys. A crossing vessel was found in 77 (55%) patients. Mean operative time was 217 minutes (range 80 to 510), estimated blood loss was 59.4 ml (range 10 to 600), mean length of hospital stay 2.1 days (range 0.75 to 7) and mean followup was 29 months (range 3 to 63). Radiographic resolution of obstruction on first postoperative diuretic renal scan or excretory urogram was noted in 134 patients (95.7%). There was a 7.1% major complication rate and a 2.9% minor complication rate. No statistically significant differences were found in any parameters among patients from the various cohorts. Conclusions: To our knowledge this review represents the largest multi-institutional experience of robotic dismembered pyeloplasty with long-term followup. Robotic pyeloplasty appears to be safe, durable and efficacious for primary and secondary ureteropelvic junction obstruction with or without concomitant stone extraction, and for patients with a solitary kidney.

Original languageEnglish
Pages (from-to)1391-1396
Number of pages6
JournalJournal of Urology
Volume180
Issue number4
DOIs
StatePublished - Oct 2008
Externally publishedYes

Keywords

  • minimally invasive
  • robotics
  • surgical procedures
  • ureteral obstruction

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