OBJECTIVE: To report a 6-year multi-institutional experience and outcomes with robot-assisted laparoscopic pyeloplasty (RLP) for the repair of ureteropelvic junction obstruction (UPJO).
PATIENTS AND METHODS: Between June 2002 and October 2008, 168 adult patients from 3 institutions underwent RLP for UPJO. A retrospective analysis of prospectively collected data were performed after institutional review board approval. Diagnosis was by intravenous urogram or computed tomography scan and diuretic renogram. All patients underwent RLP through a 4-port laparoscopic technique. Demographic, preoperative, operative, and postoperative endpoints for primary and secondary repair of UPJO were measured. Success was defined as a T½ of < 20 minutes on diuretic renogram and symptom resolution. Pain resolution was assessed by subjective patient reports.
RESULTS: Of 168 patients, 147 (87.5%) had primary repairs and 21 (12.5%) had secondary repairs. Of the secondary repairs, 57% had a crossing vessel etiology. Mean operative time was 134.9 minutes, estimated blood loss was 49 mL, and length of stay was 1.5 days. Mean follow-up was 39 months. Overall, 97.6% of patients had a successful outcome, with a 6.6% overall complication rate.
CONCLUSIONS: To our knowledge, this review represents the largest multi-institutional experience of RLP with intermediate-term follow-up. RLP is a safe, efficacious, and viable option for either primary or secondary repair of UPJO with reproducible outcomes, a high success rate, and a low incidence of complications.
Written by:
Sivaraman A, Leveillee RJ, Patel MB, Chauhan S, Bracho JE 2nd, Moore CR, Coelho RF, Palmer KJ, Schatloff O, Bird VG, Munver R, Patel VR. Are you the author?
Global Robotics Institute, Florida Hospital Celebration Health, and University of Central Florida, Celebration, FL 34747, USA.
Reference: Urology. 2012 Feb;79(2):351-5.
doi: 10.1016/j.urology.2011.10.019
PubMed Abstract
PMID: 22173173
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