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Robotic pyeloplasty

Briony K Varda, Ye Wang, Benjamin I Chung, Richard S Lee, Michael P Kurtz, Caleb P Nelson, Steven L Chang
INTRODUCTION: Since 2010, there have been few new data comparing perioperative outcomes and cost between open (OP) and robotic pyeloplasty (RP). In a post-adoption era, the value of RP may be converging with that of OP. OBJECTIVE: To 1) characterize national trends in pyeloplasty utilization through 2015, 2) compare adjusted outcomes and median costs between OP and RP, and 3) determine the primary cost drivers for each procedure. STUDY DESIGN: We performed a retrospective cohort study using the Premier database, which provides a nationally representative sample of U...
February 22, 2018: Journal of Pediatric Urology
Alexander Light, Sandeep Karthikeyan, Sachan Maruthan, Oussama ElHage, Hansjörg Danuser, Prokar Dasgupta
OBJECTIVE: To analyse the current difference between dismembered robotic-assisted pyeloplasty (RP) and laparoscopic pyeloplasty (LP) in the treatment of pelvi-ureteric junction obstruction (PUJO) patients as of June 26 2017, focusing on operative time, length of hospital stay, complication rate, and success rate. PATIENTS AND METHODS: We searched PubMed, Medline, and Embase databases, consulted experts, reviewed reference lists, used the related articles PubMed feature, and reviewed scientific meeting abstracts for eligible articles from 1993 to June 26 2017...
February 17, 2018: BJU International
Mary K Wang, Yi Li, Rachel E Selekman, Thomas Gaither, Anne Arnhym, Laurence S Baskin
INTRODUCTION: Patients undergo pediatric urologic surgery as infants and young children. OBJECTIVE: The purpose of the study was to evaluate the evolution of surgical scars over several years in order to inform parents and surgeons on the true cosmetic impact of pediatric surgery and evaluate patient scar satisfaction. STUDY DESIGN: This was a cross-sectional study where patients who have undergone urologic surgery at a young age are evaluated years later for scar satisfaction via an abbreviated validated questionnaire...
January 9, 2018: Journal of Pediatric Urology
Minki Baek, Mesrur Selcuk Silay, Jason K Au, Gene O Huang, Rodolfo A Elizondo, Kathleen Puttmann, Nicolette K Janzen, Abhishek Seth, David R Roth, Chester J Koh
BACKGROUND: Re-do pyeloplasty after failed open or laparoscopic ureteropelvic junction (UPJ) obstruction correction can be a challenging procedure because of scar formation at the previous anastomosis site and decreased vascularity of the ureter. This study compared the perioperative parameters for pediatric robot-assisted laparoscopic (RAL) primary and re-do pyeloplasties with an emphasis on the intra-operative parameters. MATERIALS AND METHODS: We compared the perioperative parameters of pediatric RAL procedures performed by a single surgeon at a tertiary care children's hospital for both primary ureteropelvic junction obstruction (UPJO) and recurrent UPJO after a previous open or laparoscopic procedure over 2013-2015...
February 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Francisco Miguel Sánchez Margallo, Idoia Díaz-Güemes, Miguel Angel Sánchez Hurtado, Javier Sánchez Fernández, Jesús Usón Gargallo, Alvaro Serrano Pascual
The lack of globally established standards for learning urological laparoscopy has not prevented laparoscopic techniques from evolution and continuous development. Laparoscopy coexists with robotic surgery today, and in the last decade there have been many techniques that have undergone a boom with the use of a laparoscopic approach (total and partial nephrectomy, pyeloplasty, colposacropexy, etc.).We intend to evaluate the progressive incorporation of different surgical techniques in the laparoscopic learning program and, on the other hand, to analyze the evolution of training programs in urological laparoscopy to bring this type of techniques within the hospital surgical activity...
January 2018: Archivos Españoles de Urología
Lee C Zhao, Aaron C Weinberg, Ziho Lee, Mark J Ferretti, Harry P Koo, Michael J Metro, Daniel D Eun, Michael D Stifelman
BACKGROUND: Minimally invasive treatment of long, multifocal ureteral strictures or failed pyeloplasty is challenging. Robot-assisted buccal mucosa graft ureteroplasty (RBU) is a technique for ureteral reconstruction that avoids the morbidity of bowel interposition or autotransplantation. OBJECTIVE: To evaluate outcomes for RBU in a multi-institutional cohort of patients treated for revision ureteropelvic junction obstruction and long or multifocal ureteral stricture at three tertiary referral centers...
November 24, 2017: European Urology
Amos Neheman, Eyal Kord, Amnon Zisman, Abd Elhalim Darawsha, Paul H Noh
PURPOSE: To compare outcomes between robotic pyeloplasty (RP) and standard laparoscopic pyeloplasty (LP) in the infant population for the treatment of ureteropelvic junction (UPJ) obstruction. MATERIALS AND METHODS: We performed a retrospective cohort study of all children under 1 year of age who underwent RP or LP at two different medical centers between October 2009 and February 2016. Patient demographics, perioperative data, complications, and results were reviewed...
December 5, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Sohrab Arora, Logan Campbell, Mouafak Tourojman, Daniel Pucheril, Lamont R Jones, Craig Rogers
OBJECTIVE: To demonstrate robot-assisted ureterolysis and buccal mucosal graft (BMG) ureteroplasty for the management of a complex, long recurrent ureteral stricture developing after ureterolysis, and also to demonstrate the use of near-infrared fluorescence (NIRF) imaging and intraoperative ureteroscopy during this procedure. METHODS: A 58-year-old man with a history of cabergoline treatment and a cardiac catheterization through the left groin presented with left flank pain and hydronephrosis...
December 2017: Urology
Jeffrey A Cadeddu
No abstract text is available yet for this article.
December 2017: Journal of Urology
K Puttmann, G O Huang, J T White, K Kukreja, A Seth, C J Koh
INTRODUCTION: We present a robot-assisted approach to surgical treatment of UPJ obstruction associated with crossed renal ectopia in a male infant. METHODS: A 31 year-old woman presented at 37 weeks gestation for prenatal hydronephrosis and delivered at 39 weeks. Renal ultrasound identified the bladder and right kidney in a crossed ectopic position in the left pelvis, and MRI showed the cystic lesion to be hydronephrosis associated with a ureteropelvic junction obstruction of the crossed ectopic right kidney...
October 27, 2017: Journal of Pediatric Urology
Anna Radford, Alexander Turner, Junaid Ashraf, Ramnath Subramaniam
INTRODUCTION: Dismembered pyeloplasty remains the gold standard for the treatment of pelviureteric junction obstruction (PUJO). Robotic approach to this procedure has proven its efficacy and is gaining popularity. The introduction of barbed sutures such as "V-Loc™" (Covidien) has provided an addition to the sutures available for pyeloplasty. This work provides our experience with the V-Loc suture for closure of pelvis in children for robotic pyeloplasty (RP). MATERIALS AND METHODS: A review of 10 pediatric RP (da Vinci Robotic System) during which the V-Loc suture was used was performed...
November 8, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Wojciech Krajewski, Joanna Wojciechowska, Janusz Dembowski, Romuald Zdrojowy, Tomasz Szydełko
Ureteropelvic junction obstruction (UPJO) causes a reduction in the urine flow from the renal pelvis into the ureter. Untreated UPJO may cause hydronephrosis, chronic infection or urolithiasis and will often result in progressive deterioration of renal function. Most cases of UPJO are congenital; however, the disease can be clinically silent until adulthood. Other causes, both intrinsic and extrinsic, are acquired and include urolithiasis, post-operative/inflammatory/ischemic stricture, fibroepithelial polyps, adhesions and malignancy...
August 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Sandra Mühlstädt, Jennifer Kranz, Joachim A Steffens, Paolo Fornara
Ureteropelvic stenosis, also known as ureteropelvic junction obstruction, is an obstruction in the region of the pyeloureteral junction resulting in a urinary discharge disorder of the renal pelvis, which requires treatment.Since the first description of pyeloplasty by Trendelenburg in 1886 and the successful establishment of open pyeloplasty by Anderson and Hynes in 1949, the treatment strategies for ureteropelvic junction obstruction have developed considerably, especially in the last two decades. Although open pyeloplasty is still considered to be the gold standard, this concept is supplemented by modern minimally-invasive techniques today...
December 2017: Aktuelle Urologie
Ram A Pathak, Manish Patel, Ashok K Hemal
Port placement for robot-assisted laparoscopic urologic surgery can be critical to effective completion of the minimally invasive procedure. An ideal port template would allow unhampered access to all critical structures during surgery, easy access for the bedside assistant, and minimization of arm collision with the fewest ports necessary to minimize cosmetic impact. We present a comprehensive plan for the placement of ports across different procedures for a variety of upper tract (radical/partial nephrectomy, retroperitoneal radical/partial nephrectomy, and pyeloplasty), lower tract (prostatectomy, and cystectomy), combined upper/lower tract (nephroureterectomy, retroperitoneal lymph node dissection), and female pelvic surgeries...
November 10, 2017: Journal of Endourology
Anne-Françoise Spinoit, Hiep Nguyen, Ramnath Subramaniam
CONTEXT: The key in the evolution towards minimally invasive surgery is the availability of appropriate equipment, especially when procedures involve children. While robotic procedures in adults continue to struggle to prove measurable advantages compared with open or classical laparoscopic ones, the use of the robotic platform (RP) in pediatric urology is steadily increasing. OBJECTIVE: To review the contemporary literature regarding the use of robotic-assisted (RA) urologic interventions in children...
April 2017: European Urology Focus
Yusuf Kibar, Serdar Yalçın, Engin Kaya, Burak Köprü, Turgay Ebiloğlu, Giray Ergin, Hüseyin Tomruk
OBJECTIVE: Robotic surgery is a leading treatment option for minimally invasive surgery and has an increasing popularity in pediatric population, as well. In this article, we reported our case series of robot-assisted laparoscopic surgery in pediatric population. MATERIAL AND METHODS: We retrospectively reviewed 29 consecutive pediatric patients who underwent robot- assisted procedures between May 2014 and October 2016. Patient demographics, hospitalization time, estimated blood loss, robotic time and total operative and peri-, and post-operative complications were evaluated...
September 2017: Turkish Journal of Urology
Anna M Zampini, Ryan Nelson, J J Haijing Zhang, Jeremy Reese, Kenneth W Angermeier, Georges-Pascal Haber
OBJECTIVE: To present the use of buccal mucosal graft (BMG) in a salvage robotic laparoscopic pyeloplasty as an alternative in the management of a recurrent ureteropelvic junction (UPJ) obstruction. METHODS: We present 2 patients with a recurrent UPJ obstruction who had previously undergone 2 prior open or robotic pyleoplasties, followed by endoscopic management. Preoperative imaging was obtained before surgical repair. The UPJ was incised and the incision extended to reveal margins of a healthy normal-caliber ureteral tissue...
July 27, 2017: Urology
Igor Sorokin, Noah E Canvasser, Brian Irwin, Riccardo Autorino, Evangelos N Liatsikos, Jeffrey A Cadeddu, Abhay Rane
INTRODUCTION: To analyze the most recent temporal trends in the adoption of urologic laparoendoscopic single-site (LESS), to identify the perceived limitations associated with its decline, and to determine factors that might revive the role of LESS in the field of minimally invasive urologic surgery. MATERIALS AND METHODS: A 15 question survey was created and sent to members of the Endourological Society in September 2016. Only members who performed LESS procedures in practice were asked to respond...
October 2017: Journal of Endourology
Barrett G Anderson, Alec J Wright, Aaron M Potretzke, R Sherburne Figenshau
INTRODUCTION AND OBJECTIVE: Retroperitoneal access for robotic renal surgery is an effective alternative to the commonly used transperitoneal approach. We describe our contemporary experience and technique for attaining retroperitoneal access. MATERIALS AND METHODS: We outline our institutional approach to retroperitoneal access for the instruction of urologists at the beginning of the learning curve. The patient is placed in the lateral decubitus position. The first incision is made just inferior to the tip of the twelfth rib as described by Hsu, et al...
July 20, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Eric J Fichtenbaum, Andrew C Strine, Charles W Concodora, Marion Schulte, Paul H Noh
Robotic upper urinary tract reconstruction (UUTR) has been widely utilized for surgical management of congenital obstruction. To further reduce morbidity and simplify postoperative care, outpatient robotic pyeloplasty (RP) and robotic ureteroureterostomy (RUU) were performed without ureteral stents, drains, or urethral catheters. The aim of the study was to assess the safety of performing tubeless robotic UUTR as an outpatient procedure. A retrospective review was performed for patients who underwent outpatient tubeless RP and RUU between July 2015 and January 2017...
June 21, 2017: Journal of Robotic Surgery
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