Role of robotics in the management of secondary ureteropelvic junction obstruction

Fatih Atug, Scott V. Burgess, Erik P Castle, Raju Thomas

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Patients with recurrent ureteropelvic junction obstruction (UPJO) present a treatment dilemma to urologists. Second-line therapies have previously been shown to fail at a higher rate than the initial therapeutic procedure. We report our experience with robotic-assisted, dismembered pyeloplasty in patients with secondary UPJO. Since November 2002, 44 robotic-assisted laparoscopic pyeloplasties (RALPs) have been performed at our institution. Of these, seven patients had undergone previous definitive treatment for UPJO. Anderson-Hynes-dismembered pyeloplasty was the preferred reconstructive technique in all patients. The patients were divided into two groups: primary pyeloplasty patients (group 1) and secondary pyeloplasty patients (group 2). Variables examined include operative time, estimated blood loss (EBL), length of hospital stay (LOS) and success rates. All operations were completed laparoscopically, and there were no conversions to open surgery in either group. Mean operative time was 60 min longer in the secondary pyeloplasty group compared with primary cases, but the EBL, LOS and success rates were similar. A patent UPJ was confirmed in both groups by renal scan and/or excretory urography (intravenous pyelogram) examinations. RALP is a viable option in select patients with recurrent UPJO after previous endoscopic or open surgical repair. As expected, operative times were longer in these patients due to a more challenging dissection (p < 0.05). However, the magnification afforded by the robot allows for a precise dissection, and subsequently, there was no significant increase in blood loss, hospital stay or perioperative morbidity in our series (p > 0.05).

Original languageEnglish (US)
Pages (from-to)9-11
Number of pages3
JournalInternational Journal of Clinical Practice
Volume60
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

Robotics
Length of Stay
Operative Time
Urography
Conversion to Open Surgery
Therapeutics
Dissection
Kidney

Keywords

  • Laparoscopy
  • Robotic-assisted
  • Secondary pyeloplasty
  • Ureteropelvic junction obstruction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Role of robotics in the management of secondary ureteropelvic junction obstruction. / Atug, Fatih; Burgess, Scott V.; Castle, Erik P; Thomas, Raju.

In: International Journal of Clinical Practice, Vol. 60, No. 1, 01.2006, p. 9-11.

Research output: Contribution to journalArticle

@article{7c076861c3954cddbf04ed2c3f76a92e,
title = "Role of robotics in the management of secondary ureteropelvic junction obstruction",
abstract = "Patients with recurrent ureteropelvic junction obstruction (UPJO) present a treatment dilemma to urologists. Second-line therapies have previously been shown to fail at a higher rate than the initial therapeutic procedure. We report our experience with robotic-assisted, dismembered pyeloplasty in patients with secondary UPJO. Since November 2002, 44 robotic-assisted laparoscopic pyeloplasties (RALPs) have been performed at our institution. Of these, seven patients had undergone previous definitive treatment for UPJO. Anderson-Hynes-dismembered pyeloplasty was the preferred reconstructive technique in all patients. The patients were divided into two groups: primary pyeloplasty patients (group 1) and secondary pyeloplasty patients (group 2). Variables examined include operative time, estimated blood loss (EBL), length of hospital stay (LOS) and success rates. All operations were completed laparoscopically, and there were no conversions to open surgery in either group. Mean operative time was 60 min longer in the secondary pyeloplasty group compared with primary cases, but the EBL, LOS and success rates were similar. A patent UPJ was confirmed in both groups by renal scan and/or excretory urography (intravenous pyelogram) examinations. RALP is a viable option in select patients with recurrent UPJO after previous endoscopic or open surgical repair. As expected, operative times were longer in these patients due to a more challenging dissection (p < 0.05). However, the magnification afforded by the robot allows for a precise dissection, and subsequently, there was no significant increase in blood loss, hospital stay or perioperative morbidity in our series (p > 0.05).",
keywords = "Laparoscopy, Robotic-assisted, Secondary pyeloplasty, Ureteropelvic junction obstruction",
author = "Fatih Atug and Burgess, {Scott V.} and Castle, {Erik P} and Raju Thomas",
year = "2006",
month = "1",
doi = "10.1111/j.1368-5031.2006.00701.x",
language = "English (US)",
volume = "60",
pages = "9--11",
journal = "International Journal of Clinical Practice",
issn = "1368-5031",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Role of robotics in the management of secondary ureteropelvic junction obstruction

AU - Atug, Fatih

AU - Burgess, Scott V.

AU - Castle, Erik P

AU - Thomas, Raju

PY - 2006/1

Y1 - 2006/1

N2 - Patients with recurrent ureteropelvic junction obstruction (UPJO) present a treatment dilemma to urologists. Second-line therapies have previously been shown to fail at a higher rate than the initial therapeutic procedure. We report our experience with robotic-assisted, dismembered pyeloplasty in patients with secondary UPJO. Since November 2002, 44 robotic-assisted laparoscopic pyeloplasties (RALPs) have been performed at our institution. Of these, seven patients had undergone previous definitive treatment for UPJO. Anderson-Hynes-dismembered pyeloplasty was the preferred reconstructive technique in all patients. The patients were divided into two groups: primary pyeloplasty patients (group 1) and secondary pyeloplasty patients (group 2). Variables examined include operative time, estimated blood loss (EBL), length of hospital stay (LOS) and success rates. All operations were completed laparoscopically, and there were no conversions to open surgery in either group. Mean operative time was 60 min longer in the secondary pyeloplasty group compared with primary cases, but the EBL, LOS and success rates were similar. A patent UPJ was confirmed in both groups by renal scan and/or excretory urography (intravenous pyelogram) examinations. RALP is a viable option in select patients with recurrent UPJO after previous endoscopic or open surgical repair. As expected, operative times were longer in these patients due to a more challenging dissection (p < 0.05). However, the magnification afforded by the robot allows for a precise dissection, and subsequently, there was no significant increase in blood loss, hospital stay or perioperative morbidity in our series (p > 0.05).

AB - Patients with recurrent ureteropelvic junction obstruction (UPJO) present a treatment dilemma to urologists. Second-line therapies have previously been shown to fail at a higher rate than the initial therapeutic procedure. We report our experience with robotic-assisted, dismembered pyeloplasty in patients with secondary UPJO. Since November 2002, 44 robotic-assisted laparoscopic pyeloplasties (RALPs) have been performed at our institution. Of these, seven patients had undergone previous definitive treatment for UPJO. Anderson-Hynes-dismembered pyeloplasty was the preferred reconstructive technique in all patients. The patients were divided into two groups: primary pyeloplasty patients (group 1) and secondary pyeloplasty patients (group 2). Variables examined include operative time, estimated blood loss (EBL), length of hospital stay (LOS) and success rates. All operations were completed laparoscopically, and there were no conversions to open surgery in either group. Mean operative time was 60 min longer in the secondary pyeloplasty group compared with primary cases, but the EBL, LOS and success rates were similar. A patent UPJ was confirmed in both groups by renal scan and/or excretory urography (intravenous pyelogram) examinations. RALP is a viable option in select patients with recurrent UPJO after previous endoscopic or open surgical repair. As expected, operative times were longer in these patients due to a more challenging dissection (p < 0.05). However, the magnification afforded by the robot allows for a precise dissection, and subsequently, there was no significant increase in blood loss, hospital stay or perioperative morbidity in our series (p > 0.05).

KW - Laparoscopy

KW - Robotic-assisted

KW - Secondary pyeloplasty

KW - Ureteropelvic junction obstruction

UR - http://www.scopus.com/inward/record.url?scp=33644848336&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644848336&partnerID=8YFLogxK

U2 - 10.1111/j.1368-5031.2006.00701.x

DO - 10.1111/j.1368-5031.2006.00701.x

M3 - Article

C2 - 16409421

AN - SCOPUS:33644848336

VL - 60

SP - 9

EP - 11

JO - International Journal of Clinical Practice

JF - International Journal of Clinical Practice

SN - 1368-5031

IS - 1

ER -