Objective: To analyze our initial experience with the practice of robotic pyeloplasty and describe its advantages over laparoscopic and open surgery.
Patients and methods: Retrospective study of the pediatric cases of pyeloplasty assisted by the robot da Vinci between March 2010 and May 2013. In all cases a transperitoneal approach was used with placement of 4 trocars (3 robotic trocars and 1 conventional laparoscopic). The technique used was the dismembered pyeloplasty Anderson-Hynes type.
Results: We operated 15 patients (12 men and 3 women) with a median age at surgery of 11 years (r: 5-18). The median weight was 40 kilos (r: 19-82). Five patients had a previous open pyeloplasty performed several years ago. All patients except but one were completed by robot. The only conversion to open surgery was performed because of difficulty in placing the double-J catheter due to a stenosis at the ureterovesical junction. They were no other intraoperative complications. The median operative time was 180 minutes (r: 110-252) and the median time for the robot docking 14 minutes (r: 4-50). The average hospital stay was 3.47 days (SD: 3). Mean follow-up was 16.97 months (SD: 10.24) and currently all patients are asymptomatic.
Conclusions: Our initial experience seems to demonstrate that, coinciding with the literature, robotic pyeloplasty improves the results of laparoscopic pyeloplasty, retaining all its advantages and radically shortening the learning curve.