Robotic-assisted laparoscopic pyeloplasty (RALP), for ureteropelvic junction obstruction (UPJO), is an alternative to open pyeloplasty in the pediatric population

2021 ◽  
Author(s):  
S. Cohen ◽  
G. Raisin ◽  
D. Dothan ◽  
J. Jaber ◽  
S. Kocherov ◽  
...  
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Pediatric Population ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Robotic Assisted ◽  
Open Pyeloplasty

scholarly journals Navigating the Difficult Robotic Assisted Pyeloplasty

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
David D. Thiel
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Patient Positioning ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Successful Completion ◽  
Port Placement ◽  
Robotic Assisted ◽  
The Face ◽  
Difficult Situations ◽  
Repair Techniques

Pyeloplasty is the gold standard therapy for ureteropelvic junction obstruction. Robotic assisted pyeloplasty has been widely adopted by urologists with and without prior laparoscopic pyeloplasty experience. However, difficult situations encountered during robotic assisted pyeloplasty can significantly add to the difficulty of the operation. This paper provides tips for patient positioning, port placement, robot docking, and intraoperative dissection and repair in patients with the difficult situations of obesity, large floppy liver, difficult to reflect colon (transmesenteric pyeloplasty), crossing vessels, large calculi, and previous attempts at ureteropelvic junction repair. Techniques presented in this paper may aid in the successful completion of robotic assisted pyeloplasty in the face of the difficult situations noted above.

Surgery for Pediatric Ureteropelvic Junction Obstruction—Comparison of Outcomes in Relation to Surgical Technique and Operating Discipline in Germany

2018 ◽  
Vol 29 (01) ◽  
pp. 033-038 ◽  
Author(s):  
M. Klora ◽  
J. Zeidler ◽  
S. Eberhard ◽  
S. Bassler ◽  
S. Mayer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Ureteropelvic Junction Obstruction ◽  
Length Of Hospital Stay ◽  
Ureteropelvic Junction ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Laparoscopic Pyeloplasty ◽  
Small Children ◽  
The Mean ◽  
Open Pyeloplasty

Introduction Surgery for ureteropelvic junction obstruction (UPJO) is performed by both pediatric surgeons (PS) and urologists (URO). The aim of this study was to analyze treatment modalities for UPJO and results in relation to the surgical technique and the operating discipline in Germany. Materials and Methods Data of patients aged 0 to 18 years were extracted from a major public health insurance (covering ∼5.7 million clients) during 2009 to 2016 and were analyzed for sociodemographic variables, surgical technique, and treating discipline. Logistic regression analysis was performed for the risk of a complication within the first postoperative year. Results A total of 229 children (31.0% female) were included. Laparoscopic pyeloplasty (LP) was performed in 58 (25.3%) patients (8.6 ± 6.4 years), and open pyeloplasty (OP) was applied in 171 (74.7%; 4.6 ± 5.9 years). LP was the dominant technique in females (p < 0.02); males preferentially underwent OP (p < 0.02). Length of hospital stay was 4.3 days (p = 0.0005) shorter in LP compared with that in OP, especially in children ≤ 2 years (6.7 days, p = 0.007). PS operated on 162 children (70.7%), and URO performed surgery on 67 patients (29.3%). The mean age of children operated by PS (3.5 ± 4.7 years) was significantly younger compared with that operated by URO (10.8 ± 6.5 years, p < 0.0001). Complication rates were independent of surgical technique or treating specialty. Conclusion In Germany, UPJO was treated by LP in 25.3% of patients, which was associated with a shorter length of stay, especially in children ≤ 2 years. Complication rates were independent of the operating specialty and surgical technique. Therefore, LP should be further promoted for the treatment of UPJO in small children.

scholarly journals A comparison between laparoscopic and robotic-assisted laparoscopic pyeloplasty in patients with ureteropelvic junction obstruction

2020 ◽  
Author(s):  
Niwat Lukkanawong ◽  
Masashi Honda ◽  
Shogo Teraoka ◽  
Yusuke Kimura ◽  
Tetsuya Yumioka ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Operative Time ◽  
Ureteropelvic Junction Obstruction ◽  
Laparoscopic Group ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Robotic Group ◽  
Robotic Assisted ◽  
Drain Removal ◽  
Significant Difference

Abstract Background The aim of this study is to compare the results of laparoscopic pyeloplasty and robotic-assisted laparoscopic pyeloplasty in patients with ureteropelvic junction obstruction. Methods Between March 2008 and May 2019, the patients who underwent retroperitoneal laparoscopic or robotic-assisted laparoscopic pyeloplasty in our institution were retrospectively reviewed. Results Thirteen patients underwent laparoscopically, and 12 patients underwent robotic surgery. The significant difference was found in median operative time between laparoscopic group (296 minutes) and robotic group (199 minutes) (P = 0.001). The median time for drain removal in laparoscopic group was longer than robotic group (3 vs 2 days, respectively, P = 0.029). Conclusions Laparoscopic and robotic-assisted laparoscopic pyeloplasty is safe and excellent success rates in patients with ureteropelvic junction obstruction. However, our experience study suggested that robotic surgery improves a total operative time, decreases drain removal time and less intraoperative blood loss than laparoscopic approach.

Laparoscopic pyeloplasty versus open pyeloplasty for recurrent ureteropelvic junction obstruction in children

2016 ◽  
Vol 12 (6) ◽  
pp. 401.e1-401.e6 ◽  
Author(s):  
A.M. Abdel-Karim ◽  
A. Fahmy ◽  
A. Moussa ◽  
H. Rashad ◽  
M. Elbadry ◽  
...  
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Open Pyeloplasty

scholarly journals The Role of Percutaneous Endopyelotomy for Ureteropelvic Junction Obstruction

2007 ◽  
Vol 89 (2) ◽  
pp. 153-156 ◽  
Author(s):  
NJ Rukin ◽  
DA Ashdown ◽  
P Patel ◽  
S Liu
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Operating Time ◽  
Primary Treatment ◽  
Ureteropelvic Junction ◽  
Salvage Procedure ◽  
Success Rates ◽  
Laparoscopic Pyeloplasty ◽  
Retrospective Audit ◽  
Open Pyeloplasty

INTRODUCTION Over the last 20 years, the surgical management of ureteropelvic junction obstruction (UPJO) has been revolutionised by the development of endourological instrumentation and several minimally invasive procedures including: antegrade or retrograde endopyelotomy, retrograde balloon dilatation, and laparoscopic pyeloplasty. Currently, in our department, we offer percutaneous antegrade endopyelotomy (PAE) as primary treatment of UPJO in adults, believing it offers less morbidity, better cosmetic results, and quicker operating time compared with open pyeloplasty. PATIENTS AND METHODS We performed a retrospective audit of our results for the 14 patients who underwent percutaneous antegrade endopyelotomy between January 2000 and May 2004. RESULTS Mean operative time was 53 min (range, 30–80 min), mean in-patient stay was 3.8 days (range, 2–7 days), and there were no major postoperative complications for this series with mean follow-up of 31.8 months (range, 12–52 months). Eleven out of the 14 patients (79%) showed radiological improvement on their 3-month MAG 3 (mercaptoacetyl-triglycyl) renogram, and 13 out of the 14 (93%) patients reported significant reduction or resolution of pain, compared with their preoperative state. CONCLUSIONS The majority of urologists still offer open pyeloplasty as primary treatment for UPJO with laparoscopic pyeloplasty currently an evolving procedure in the UK. Our series reports comparable success rates for PAE compared to other series. Despite these results, we feel that the future role of percutaneous endopyelotomy will be as a salvage procedure following failed open or laparoscopic surgery. However, in patients with concurrent stone disease or requiring antegrade ureteric access, percutaneous endopyelotomy would be suitable as a primary treatment option.

scholarly journals P117 Surgical management of Ureteropelvic Junction Obstruction (UPJO) in Neonates amid COVID-19 pandemic; Review of Literature and a Cohort Study in Iran

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Alireza Sherafat ◽  
Mohammad Ali Ashraf ◽  
Sarina Ahmadian ◽  
Arni Sarian ◽  
Elham Ramezannezhad ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Management ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Surgical Approaches ◽  
Original Research ◽  
Review Of Literature ◽  
Laparoscopic Pyeloplasty ◽  
Open Pyeloplasty ◽  
Laparoscopic Assisted

Abstract Introduction The current study presents a systematic review of literature on surgical management of ureteropelvic junction obstruction (UPJO) alongside an ongoing cohort study of neonates presenting with high grades of hydronephrosis due to UPJO requiring urgent treatment in a developing country amid the COVID-19 pandemic. The aim of this study is to investigate the efficacy and cost effectiveness of laparoscopic-assisted pyeloplasty. Methods Patients’ demographics, clinical presentations and treatment outcomes are recorded. The cohort is classified into 3 groups based on type of surgical treatment offered including open, laparoscopic and laparoscopic-assisted pyeloplasty. All patients admitted with grade 3-4 hydronephrosis due to UPJO are included. Patients with UPJO as part of a complex multisystemic syndrome are excluded. Literature review was conducted from 2000/1/1 to 2020/1/1 to include all original research papers on surgical management of UPJO. The age group was limited to neonates (under 1 year-old). Results 32 articles were included in the review. 20 papers (62.5%) recommended open pyeloplasty, 10 papers (31.3%) recommended laparoscopic pyeloplasty and 2 papers (6.25%) recommended laparoscopic-assisted pyeloplasty. The cohort study is currently recruiting patients treated by the 3 surgical approaches. Conclusion The majority of studies are focusing on open pyeloplasty. However, as more surgeons are going through the learning curve of laparoscopic pyeloplasty, the trend is towards more laparoscopic management in the future. It is important to discover the advantages of laparoscopic-assisted approach as a new technique to improve the outcome and shorten the hospital stay amid the COVID-19 pandemic.

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