Laparoscopic dismembered pyeloplasty is an established procedure for treatment of ureteropelvic junction obstruction, with results comparable to traditional open pyeloplasty. However, the procedure is technically challenging and the learning curve is high. Robotic surgery has gained increasing popularity in the urologic community, offering advantages of improved visualization, ergonomics, and range of motion of instruments to provide improved operative performance and simplified suturing. We describe our technique for robotic assisted laparoscopic pyeloplasty.

From October 2005 to November 2006, 31 robotic assisted dismembered pyeloplasties were performed at Thomas Jefferson University Hospital. The four-armed da Vinci® robot was used in all cases, using a four-port, transperitoneal template. The procedure was performed similarly to conventional laparoscopic dismembered pyeloplasty.

Of the 31 patients, 19 (61%) were female and 12 (39%) were male. Mean age was 40.6 years (range 17-82). The mean operative time was 187 minutes (range 120-420), mean estimated blood loss was 37.4ml (range 25-150), and mean length of hospital stay was 2.1 days (range1-4). Two patients required conversion to an open procedure.

Robotic assisted dismembered pyeloplasty is a reasonable and feasible alternative to conventional laparoscopic dismembered pyeloplasty.