Transmesenteric robot-assisted pyeloplasty for ureteropelvic junction obstruction in horseshoe kidney

Potretzke, Aaron M.; Mohapatra, Anand; Larson, Jeffrey; Benway, Brian M.

doi:10.1590/s1677-5538.ibju.2015.0315

Cited by 5 publications

(3 citation statements)

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“…In addition to the benefits of robotic surgery itself, we aim to demonstrate that robotic surgery in this particular case was preferable to other techniques, given the anatomical exclusivity of a horseshoe kidney. This case report discusses comparisons to other similar case reports [4][5][6][7] and cohort studies, 8,9 analysing the aforementioned aspects, as well as the use of stents, drains, and catheters.…”

Section: Introductionmentioning

confidence: 83%

“…A further example of robotic pyeloplasty was described by authors in Los Angeles in 2016. 5 A 28-year-old female underwent a robotic pyeloplasty via a trans-mesenteric approach due to the horseshoe kidney and unique anatomy of this patient. The authors also used an Anderson-Hynes technique, and the patient was also discharged on day 2 post-operation, as was the case for our patient.…”

Section: Discussionmentioning

confidence: 99%

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Robotic pyeloplasty in a horseshoe kidney: A case report

Bennett

Zelhof

2022

Journal of Clinical Urology

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Objective: To deliver a case report showing that robotic pyeloplasty in a patient with a horseshoe kidney is not only successful but also potentially superior to laparoscopic surgery. To the best of our knowledge, this is the first case report of its kind in the United Kingdom. Method: PubMed was used to do a literature search. We have excluded papers that were written in foreign languages, or were paediatric case studies. Results: Horseshoe kidneys are the commonest congenital abnormality of the renal and are often associated with pelvic-ureteric junction obstruction (PUJO) – in the order of 30%. Minimally invasive surgery is the gold standard for management of PUJO. With the advancement of the Da Vinci robot, this case report presents a patient undergoing pyeloplasty in a horseshoe kidney with PUJO on the left side, using a robotic technique. We performed a robotic pyeloplasty on a 32-year-old woman, with a horseshoe kidney. We felt this is a case worth discussion, giving the alteration in the surgical technique in conjunction with the anatomical abnormalities, and the lack of similar reported cases in the literature. We propose that in some cases, the robotic operative technique is superior to standard laparoscopic technique. Although there is an increased cost when using the Da Vinci robot, this may be offset by the 3D visualisation, enhanced dexterity, tremor filtering and movement scaling, increased range of motion, as well as the reduction of operative time, hospital stay, blood loss, complications, and indeed patient satisfaction. In addition to the benefits of robotic surgery itself, we demonstrate that robotic surgery in this particular case was preferable to other techniques, given the anatomical exclusivity of a horseshoe kidney. Conclusion: We propose that in some cases, the robotic operative technique is superior to other minimal access techniques in urological surgery. Level of Evidence: 4

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Section: Introductionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Robotic pyeloplasty in a horseshoe kidney: A case report

Bennett

Zelhof

2022

Journal of Clinical Urology

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“…This procedure can be performed transperitoneally or retroperitoneally [ 13 , 14 ]. Moreover, the use of the transmesenteric approach has also been described, particularly on the left side, which avoids reflection of the colon [ 15 ].…”

Section: Robotic Pyeloplastymentioning

confidence: 99%

The robot-assisted ureteral reconstruction in adult: A narrative review on the surgical techniques and contemporary outcomes

Bhat

Moschovas

Patel

et al. 2021

Asian Journal of Urology

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Despite the rapid increase in the use of robotic surgery in urology, the majority of ureteric reconstruction procedures are still performed using laparoscopic or open approaches. This is primarily due to uncertainty regarding the advantages of robotic approaches over conventional ones, and the unique difficulty in identifying the specific area of interest due to the lack of tactile feedback from the current robotic systems. However, with the potential benefits of minimal invasiveness, several pioneering reports have been published on robotic surgery in urology. By reviewing the literature on this topic, we aimed to summarize the techniques, considerations, and consistent findings regarding robotic ureteral reconstruction in adults. Robotic applications for ureteral surgery have been primarily reported for pediatric urology, especially in the context of relieving a congenital obstruction in the ureteral pelvic junction. However, contemporary studies have also consistently demonstrated that robotic surgery could be a reliable option for malignant, iatrogenic, and traumatic conditions, which generally occur in adult patients. Nevertheless, the lack of comparative studies on heterogeneous hosts and disease conditions make it difficult to determine the benefit of the robotic approach over the conventional approach in the general population; thus, qualified prospective trials are needed for wider acceptance. However, contemporary reports have demonstrated that the robotic approach could be an alternative option for ureteral construction, even in the absence of haptic feedback, which can be compensated by various surgical techniques and enhanced three-dimensional visualization.

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