Clinical application of robot-assisted laparoscopy in ureteropelvic junction obstruction

doi:10.3877/cma.j.issn.1674-3253.2022.04.006

Abstract

Abstract:

Objective

To explore the value of robot-assisted laparoscopy in the treatment of ureteropelvic junction obstruction (UPJO).

Methods

Medical records were collected from 99 patients who underwent robot-assisted ureteropelvic dissociation plasty in our hospital from October 2014 to December 2019, including 74 males and 25 females, with an average age of (28±15) years. There were 54 cases with left side UPJO, 40 cases right side and 5 cases bilateral side. 16 cases were treated with concurrent diseases during operation, including 13 cases with ipsilateral urolithiasis.

Results

All the 99 patients received the robot-assisted ureteropelvic dissociation plasty, and the disease was treated simultaneously. The operative time was (179±58) min. The time to drainage and catheter removal was (5.2±2.0) days and (7.5±2.7) days. No intraoperative complications occurred, no conversion to open surgery. Clavien classification-Dindo (grade I-Ⅱ) 13 cases (13.1%). The average length of stay was (14±4) days and the average postoperative hospital stay was (7.0±2.2) days. The patients were followed up for (11.9±0.4) months without recurrence.

Conclusion

Robot-assisted laparoscopic surgery for the treatment of UPJO has the advantages of less trauma, clear operative field, high success rate of surgery, quick recovery and fewer complications, and can simultaneously deal with complicating diseases, with obvious clinical application advantages.

Key words: Robot, Laparoscopy, UPJO

Qinzhou Yu, Xingliang Feng, Zhengyao Song, Sheng Tai, Jun Zhou, Zongyao Hao, Chaozhao Liang, Song Fan. Clinical application of robot-assisted laparoscopy in ureteropelvic junction obstruction[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(04): 311-315.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2022.04.006

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2022/V16/I04/311

References 20

[1]	Lucas JW, Ghiraldi E, Ellis J, et al. Endoscopic management of ureteral strictures: an update[J]. Curr Urol Rep, 2018, 19(4): 24.
[2]	Wang J, Xiong S, Fan S, et al. Appendiceal onlay flap ureteroplasty for the treatment of complex ureteral strictures: initial experience of nine patients[J]. J Endourol, 2020, 34(8): 874-881.
[3]	Higgins M, Saltzman AF. Intraoperative decision-making: thermal injury during robotic pyeloplasty[J]. Urology, 2020, 141: 178.
[4]	Kaouk JH, Garisto J, Eltemamy M, et al. Robot-assisted surgery for benign distal ureteral strictures: step-by-step technique using the SP((R) surgical system[J]. BJU Int, 2019, 123(4): 733-739.
[5]	Buffi NM, Lughezzani G, Hurle R, et al. Robot-assisted surgery for benign ureteral strictures: experience and outcomes from four tertiary care institutions[J]. Eur Urol, 2017, 71(6): 945-951.
[6]	Schuessler WW, Grune MT, Tecuanhuey LV, et al. Laparoscopic dismembered pyeloplasty[J]. J Urol, 1993, 150(6): 1795-1799.
[7]	汪朔，王平. 腹腔镜处理肾盂输尿管交界处狭窄的技术探讨(附光盘)[J]. 现代泌尿外科杂志, 2015, 20(5): 293-296.
[8]	Bozzini G, Gidaro S, Taverna G. Robot-Assisted Laparoscopic Partial Nephrectomy with the ALF-X Robot on Pig Models[J]. Eur Urol, 2016, 69(2): 376-377.
[9]	Wang Q, Lu Y, Hu H, et al. Management of recurrent ureteral stricture: a retrospectively comparative study with robot-assisted laparoscopic surgery versus open approach[J]. Peerj, 2019, 7: e8166.
[10]	韩晓敏，陈敏，肖亚军, 等. 腹腔镜离断式肾盂输尿管成形术治疗UPJO肾积水230例经验总结[J]. 临床泌尿外科杂志, 2019, 34(5): 353-357.
[11]	谢汉平，徐耀鹏，文瀚东, 等. 机器人联合膀胱软镜治疗肾盂输尿管连接处狭窄合并继发性肾结石一例报告及文献复习[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2020, 14(1): 61-63.
[12]	Popelin MB, Pinar U, Benamran D, et al. Functional outcomes after robot-assisted pyeloplasty for ureteropelvic junction obstruction: A bi-centre experience[J]. Int J Med Robot, 2021, 17(2): e2201.
[13]	Mantica G, Ambrosini F, Parodi S, et al. Comparison of safety, efficacy and outcomes of robot assisted laparoscopic pyeloplasty vs conventional laparoscopy[J]. Res Rep Urol, 2020, 12: 555-562.
[14]	高旭，王海峰，鲁欣, 等. 机器人辅助的腹腔镜与普通腹腔镜下UPJ成型的比较研究[J]. 微创泌尿外科杂志, 2012, 1(1): 70-72.
[15]	蒋昊，刘光香，赵晓智, 等. 机器人辅助经腹腹腔镜与传统经腹腹腔镜肾盂输尿管成形术治疗肾盂输尿管连接部梗阻的临床对照研究[J]. 现代泌尿外科杂志, 2017, 22(7): 495-499.
[16]	Rasool S, Singh M, Jain S, et al. Comparison of open, laparoscopic and robot-assisted pyeloplasty for pelviureteric junction obstruction in adult patients[J]. J Robot Surg, 2020, 14(2): 325-329.
[17]	Lee M, Lee Z, Strauss D, et al. Multi-institutional experience comparing outcomes of adult patients undergoing secondary versus primary robotic pyeloplasty[J]. Urology, 2020, 145: 275-280.
[18]	Zhang P, Shi T, Fam X, et al. Robotic-assisted laparoscopic pyeloplasty as management for recurrent ureteropelvic junction obstruction: a comparison study with primary pyeloplasty[J]. Transl Androl Urol, 2020, 9(3): 1278-1285.
[19]	Esposito C, Masieri L, Castagnetti M, et al. Robot-assisted vs laparoscopic pyeloplasty in children with uretero-pelvic junction obstruction (UPJO): technical considerations and results[J]. J Pediatr Urol, 2019, 15(6): 661-667.
[20]	Kang SK, Jang WS, Kim SW, et al. Robot-assisted laparoscopic single-port pyeloplasty using the da Vinci SP(R) system: initial experience with a pediatric patient[J]. J Pediatr Urol, 2019, 15(5): 576-577.

Please choose a citation manager

Content to export