Comparison of Robot-assisted Versus Conventional Laparoscopic Transperitoneal Pyeloplasty for Patients With Ureteropelvic Junction Obstruction: A Single-center Study

• Published in: Urology (Ridgewood, N.J.) N.J.), 2011-03, Vol.77 (3), p.730-734
• Main Authors: Bird, Vincent G, Leveillee, Raymond J, Eldefrawy, Ahmed, Bracho, Jorge, Aziz, Mohammed S
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Female; Humans; Kidney Pelvis - surgery; Kidneys; Laparoscopy - methods; Male; Medical sciences; Nephrology. Urinary tract diseases; Postoperative Complications; Robotics - methods; Ureteral Obstruction - surgery; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2010.07.540

Objectives To compare conventional laparoscopic pyeloplasty (C-LPP) and robotic-assisted laparoscopic pyeloplasty (RA-LPP), which are both used for correction of ureteropelvic junction obstruction. Robotic assistance may further expedite dissection and reconstruction; however it is unclear whether this has an impact on results. Methods Between 1999 and 2009, 172 conventional or robotic-assisted transperitoneal laparoscopic pyeloplasties were performed by 2 surgeons. Data were obtained from our prospective database, patient charts, and radiographic reports. Statistical analysis was performed for the groups. Results A total of 98 patients underwent R-LPP, and 74 underwent C-LPP. Mean age, body mass index, and gender distribution were similar for the groups. Of the patients, 22 (12.8%) had secondary ureteropelvic junction obstruction. Operative time in minutes was 189.3 ± 62 for RA-LPP, and 186.6 ± 69 for C-LPP ( P = .69) respectively. Intraoperative and postoperative complication rates for RA-LPP and C-LPP were 1%, 5.1% and 0, 2.7% ( P = .83 and .85) respectively. There was no significant difference in mean suturing time: 48.3 ± 30 and 60 ± 46 ( P = .30) for RA-LPP and C-LPP, respectively. Long-term follow up (minimum 6 months; available for 136 patients) showed 93.4% and 95% radiographic success rate based upon diuretic scintirenography for RA-LPP and C-LPP respectively. Conclusions Operative time, perioperative outcome and success rates are similar for C-LPP and RA-LPP. Mean suturing time for RA-LPP was shorter; however, there was no significant time difference in total operative time. Complications for both procedures are infrequent. Success rates, as measured by diuretic scintirenography, are high for the 2 procedures.