Robotic pyeloplasty: Initial experience of a single UK centre

Abstract

Objective:

We present our experience and outcomes at a single UK robotic centre of robotic-assisted laparoscopic dismembered pyeloplasty for the treatment of pelvo-ureteric junction obstruction (PUJO).

Materials and methods:

Between July 2009 and July 2013, 20 robotic-assisted transperitoneal laparoscopic pyeloplasties were performed by four surgeons. Data were obtained from patient case notes, patient charts, and radiographic reports.

Results:

A total of 20 robot-assisted laparoscopic dismembered pyeloplasties were performed in 11 men and nine women. Mean age at treatment was 37 years (range 16–75) with an average follow-up of 14 months (five to 24). The average console time was two hours: 8 minutes (1:30–3:30), mean drop in haemoglobin 0.67 g/dl (−3.5 to +1.3), mean change in serum creatinine −0.5 (−22 to +18). The average time to post-operative catheter removal was 1.64 days (one to two), to post-operative drain removal 2.43 days (two to three), and to discharge 2.8 days (two to four). The average time to stent removal was 6.1 weeks (six to eight). At the mean follow-up of 14 months no major perioperative complications had occurred and no patients were re-admitted within 30 days of operation. The success rate was 95%; one patient required a second procedure in the form of an open redo-pyeloplasty because of continued pain and radiographic evidence of continued obstruction.

Conclusions:

These results suggest that robotic-assisted laparoscopic pyeloplasty is a feasible treatment for PUJO in a UK centre. Low rates of morbidity, short post-operative stay and high success rates at our centre are comparable with other series. Longer follow-up of this cohort is needed to demonstrate durable and effective outcomes.