Robotic-assisted laparoscopic pyeloplasty as management for recurrent ureteropelvic junction obstruction: a comparison study with primary pyeloplasty

Zhang, Peng; Shi, Taoping; Fam, Xeng Inn; Gu, Liangyou; Xuan, Yundong; Yang, Luojia; Wang, Baojun; Ai, Xing; Jia, Zhuomin; Li, Hongzhao; Zhang, Xu; Ma, Xin

doi:10.21037/tau.2020.03.25

Cited by 9 publications

(4 citation statements)

References 27 publications

(30 reference statements)

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“…Compared with previous reports of LP for UPJO, CMLP based on membrane anatomy has a superior clear surgical field. In terms of the success rate, we achieved a satisfying overall success rate (95.83%) compared with the published reports on LP (92–98.44%) [22‒24]. The average postoperative hospital stay was 9.31 days, which was high compared to that reported in the existing literature on LP (4.2–7.48 days) [25, 26].…”

Section: Discussionsupporting

confidence: 52%

Initial Experience with the Comprehensive Modified Laparoscopic Pyeloplasty Technique Based on Membrane Anatomy for Treating Ureteropelvic Junction Obstruction

Zhong

et al. 2021

Urol Int

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Objective: The aim of the objective was to present our initial experience and evaluate the feasibility of the novel comprehensive modified laparoscopic pyeloplasty (CMLP) technique based on membrane anatomy. Materials and Methods: Forty-eight patients underwent CMLP from February 2016 to October 2020. CMLP involves the following: dissection of the ureter was based on the fascia or fusion fascia formed by embryonic development. The ureter was separated from the ureteral sheath, and the pelvis and ureter were incised with incomplete amputation. The first stitch was placed between the lower point of the spatulated ureter and the lowest corner of the renal pelvis to ensure correct orientation of the anastomosis; anastomosis of the renal pelvis and ureter was performed using the touchless technique. Results: All CMLPs were completed successfully without conversion. The mean overall operating time was 230.96 min. The median estimated blood loss was 50.00 (interquartile range 20.00–57.50) mL. The average postoperative hospital stay was 9.31 days. The average follow-up time was 24.73 months. No major complications occurred. In 1 case, revision laparoscopic pyeloplasty was performed, but the obstruction persisted after double J stent removal, so ultimately, the double J stent required regular replacement. Another asymptomatic patient with hydronephrosis experienced failed treatment and is still under follow-up. The overall success rate was 95.83% (46/48). The success rate in patients with recurrent ureteropelvic junction obstruction (UPJO) was 87.5% (7/8). Conclusions: CMLP is a practical and effective treatment option for UPJO with a high success rate. An advantage of CMLP is the clear surgical field.

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Section: Discussionsupporting

confidence: 52%

Initial Experience with the Comprehensive Modified Laparoscopic Pyeloplasty Technique Based on Membrane Anatomy for Treating Ureteropelvic Junction Obstruction

Zhong

et al. 2021

Urol Int

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“…In addition, four patients experienced a post operative urinary infection and received antibiotic therapy. Our results align with previous research, which supports RLP as a safe procedure with a high success rate in terms of symptom relief and the complication burden (8,9,14,15). At three months follow-up, no obstruction on isotopic renography was found in 64% of the patients.…”

Section: Discussionsupporting

confidence: 91%

“…Initially, open surgery was the sole option; however, advancements in surgical technology over recent decades have allowed for minimally invasive approaches, such as laparoscopic and robotic pyeloplasty, to now standard as the reference interventions (7). Currently, robotic assisted laparoscopic pyeloplasty (RLP) is reported to yield success rates exceeding 90% (8)(9)(10)(11). The robotic-assisted approach for pyeloplasty is further associated with short hospital stay and low complication rates (12).…”

Section: Original Papermentioning

confidence: 99%

Robotic-assisted laparoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction. How should success be determined?

Lien,

Æsøy,

Hjelle

et al. 2024

Arch Ital Urol Androl

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Background: Ureteropelvic junction obstruction (UPJO) is characterised by stenosis of the ureteral lumen at the level of the renal pelvis and proximal ureter. At Haukeland University Hospital, robotic-assisted laparoscopic pyeloplasty (RLP) for UPJO has been performed since 2014. The aim of this study was to evaluate the results of the treatment and consider what determines treatment success. Materials and methods: Retrospective review was performed of consecutive patients undergoing RLP between 2014-2022. Outcomes of interest included symptom relief, complication rates and renographic findings at follow-up. Treatment success was defined in terms of symptom improvement and/or improvement as well as relief of obstruction on renography. Results: In total, 95 RLPs were performed in 54 women and 41 men, with a mean age of 40 years (IQR: 21-58). Flank pain was the most frequent presenting complaint (n = 81, 85%) followed by infection (n = 33, 35%). More than one indication for surgery was present in 1/3 of the patients. Urodynamic relevant obstruction on renography was found in 62 patients (65%) preoperatively. Mean operative time was 123 minutes (range 60-270). Two patients experienced minor intraoperative complications. At three months follow-up, 91% of patients had symptom relief, and no obstruction on renography was recorded in 64%. There was no significant association between improvement in symptoms and renography findings at follow-up, p = 1. Conclusions: RLP can deliver a high success rate in terms of symptom relief and few complications. There was no association between renography findings and symptom relief at follow-up. Success after surgery should be determined by symptom relief rather than renography findings.

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“…[ 6 ] In cases of redo AH pyeloplasty for previous failed pyeloplasty, the result is 77.8%–100%. [ 7 ]…”

Section: Techniquesmentioning

confidence: 99%

Techniques in minimally invasive transperitoneal pyeloplasty: A compilation

Mallikarjuna,

Ghouse,

Madduri

et al. 2023

Urology Annals

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Context: Minimally invasive management (laparoscopic/robot assisted) is currently the standard of care for managing pelvi ureteric junction obstruction (PUJO). Open techniques of management of PUJO are well described in literature. However, there appears to be relative lack of description of minimally invasive techniques in the literature. Objective: This article is aimed at describing in detail, with images, the various techniques and modifications in laparoscopic or robot-assisted management of PUJO. Evidence Acquisition: A review of literature on PubMed was performed and all articles which detailed any technique of minimally invasive pyeloplasty were included. Evidence Synthesis: The various techniques of minimally invasive pyeloplasty as well as the authors’ techniques are compiled and described in detail with intraoperative images. Conclusions: Operative techniques of minimally invasive pyeloplasty are not well described in literature. We have attempted to present a comprehensive resource of different techniques of minimally invasive pyeloplasty and the clinical scenarios in which they may be appropriate. This should prove to be a useful reference to the practicing urologist. Patient Summary: In this paper, we have compiled the various surgical techniques of treating obstruction at the PUJ of the kidney along with intraoperative photograph.

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Robotic-assisted laparoscopic pyeloplasty as management for recurrent ureteropelvic junction obstruction: a comparison study with primary pyeloplasty

Cited by 9 publications

References 27 publications

Initial Experience with the Comprehensive Modified Laparoscopic Pyeloplasty Technique Based on Membrane Anatomy for Treating Ureteropelvic Junction Obstruction

Initial Experience with the Comprehensive Modified Laparoscopic Pyeloplasty Technique Based on Membrane Anatomy for Treating Ureteropelvic Junction Obstruction

Robotic-assisted laparoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction. How should success be determined?

Techniques in minimally invasive transperitoneal pyeloplasty: A compilation

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