Skip to main content
Log in

Robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction: comparison between pediatric and adult patients-Japanese series

Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

Robotic-assisted procedures are gaining traction as a viable form of minimally invasive surgery in the field of reconstructive surgery. In this article, the aim is to present our initial experience and clinical outcomes of robot-assisted laparoscopic pyeloplasty (RAL-P). We performed RAL-P in 22 patients for the management of ureteropelvic junction obstruction between December 2012 and August 2015. The da Vinci® S surgical system was utilized for all cases. All procedures were performed via a transperitoneal approach. We assessed perioperative outcomes, and furthermore, compared between pediatric and adult patients undergoing this procedure. Dismembered procedures were performed in 19 patients. Three patients underwent Y-V plasty, and two patients who experienced failure during the primary pyeloplasty had to undergo reoperation. Although the console time for pediatric patients was significantly shorter than that of adults (123.1 ± 18.3, 162.4 ± 23.9 min, respectively, p < 0.001), success rate was not significantly different between pediatric and adults (100 vs 90 %, p = 0.512). According to a comparison of surgical outcomes by age, the console time was significantly shorter in pediatric than in adult patients. This finding may be attributable to the differences in intraabdominal fatty tissues. Besides, RAL-P with Y–V plasty was applicable even for cases of failed pyeloplasty. In conclusion, the surgical outcomes of RAL-P were favorable and safe for both pediatric and adult patients, and comparable to findings of previous reports. To our knowledge, this is the first report of a case series of RAL-P in Japan.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sukumar S, Bhandari M, Menon M (2012) The evolution of robotic surgery and its clinical applications. In: Gundeti MS (ed) Pediatric robotic and reconstructive urology: a comprehensive guide. Blackwell Publishing Ltd, Chichester, pp 3–9

    Google Scholar 

  2. Trevisani LF, Nguyen HT (2013) Current controversies in pediatric urologic robotic surgery. Curr Opin Urol 23(1):72–77. doi:10.1097/MOU.0b013e32835b0ad2

    Article  PubMed  Google Scholar 

  3. Persky L, Krause JR, Boltuch RL (1977) Initial complications and late results in dismembered pyeloplasty. J Urol 118(1 Pt 2):162–165

    CAS  PubMed  Google Scholar 

  4. Kavoussi LR, Peters CA (1993) Laparoscopic pyeloplasty. J Urol 150(6):1891–1894

    CAS  PubMed  Google Scholar 

  5. Schuessler WW, Grune MT, Tecuanhuey LV, Preminger GM (1993) Laparoscopic dismembered pyeloplasty. J Urol 150(6):1795–1799

    CAS  PubMed  Google Scholar 

  6. Peters CA, Schlussel RN, Retik AB (1995) Pediatric laparoscopic dismembered pyeloplasty. J Urol 153(6):1962–1965

    Article  CAS  PubMed  Google Scholar 

  7. Piaggio LA, Franc-Guimond J, Noh PH et al (2007) Transperitoneal laparoscopic pyeloplasty for primary repair of ureteropelvic junction obstruction in infants and children: comparison with open surgery. J Urol 178(4 Pt 2):1579–1583. doi:10.1016/j.juro.2007.03.159

    Article  PubMed  Google Scholar 

  8. Gettman MT, Peschel R, Neururer R, Bartsch G (2002) A comparison of laparoscopic pyeloplasty performed with the daVinci robotic system versus standard laparoscopic techniques: initial clinical results. Eur Urol 42(5):453–457 (discussion 457–458)

    Article  PubMed  Google Scholar 

  9. Yoshida M, Furukawa T, Morikawa Y, Kitagawa Y, Kitajima M (2010) The developments and achievements of endoscopic surgery, robotic surgery and function-preserving surgery. Jpn J Clin Oncol 40(9):863–869. doi:10.1093/jjco/hyq138

    Article  PubMed  Google Scholar 

  10. Orvieto MA, Large M, Gundeti MS (2012) Robotic paediatric urology. BJU Int 110(1):2–13. doi:10.1111/j.1464-410X.2011.10877.x

    Article  PubMed  Google Scholar 

  11. Lucas SM, Sundaram CP, Wolf JS Jr et al (2012) Factors that impact the outcome of minimally invasive pyeloplasty: results of the Multi-institutional Laparoscopic and Robotic Pyeloplasty Collaborative Group. J Urol 187(2):522–527. doi:10.1016/j.juro.2011.09.158

    Article  PubMed  Google Scholar 

  12. Dangle PP, Kearns J, Anderson B, Gundeti MS (2013) Outcomes of infants undergoing robot-assisted laparoscopic pyeloplasty compared to open repair. J Urol. doi:10.1016/j.juro.2013.07.063

    Google Scholar 

  13. Kojima Y, Umemoto Y, Mizuno K et al (2011) Comparison of laparoscopic pyeloplasty for ureteropelvic junction obstruction in adults and children: lessons learned. J Urol 185(4):1461–1467. doi:10.1016/j.juro.2010.11.048

    Article  PubMed  Google Scholar 

  14. Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. doi:10.1097/SLA.0b013e3181b13ca2

    Article  PubMed  Google Scholar 

  15. Tasian GE, Casale P (2015) The robotic-assisted laparoscopic pyeloplasty: gateway to advanced reconstruction. Urol Clin North Am 42(1):89–97. doi:10.1016/j.ucl.2014.09.008

    Article  PubMed  Google Scholar 

  16. Monn MF, Bahler CD, Schneider EB, Sundaram CP (2013) Emerging trends in robotic pyeloplasty for the management of ureteropelvic junction obstruction in adults. J Urol 189(4):1352–1357. doi:10.1016/j.juro.2012.10.001

    Article  PubMed  Google Scholar 

  17. Passerotti CC, Passerotti AM, Dall’Oglio MF et al (2009) Comparing the quality of the suture anastomosis and the learning curves associated with performing open, freehand, and robotic-assisted laparoscopic pyeloplasty in a swine animal model. J Am Coll Surg 208(4):576–586. doi:10.1016/j.jamcollsurg.2009.01.010

    Article  PubMed  Google Scholar 

  18. Tasian GE, Wiebe DJ, Casale P (2013) Learning curve of robotic assisted pyeloplasty for pediatric urology fellows. J Urol 190(4 Suppl):1622–1626. doi:10.1016/j.juro.2013.02.009

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hayashi Y, Mizuno K, Kurokawa S et al (2014) Extravesical robot-assisted laparoscopic ureteral reimplantation for vesicoureteral reflux: initial experience in Japan with the ureteral advancement technique. Int J Urol. doi:10.1111/iju.12483

    Google Scholar 

  20. Szydelko T, Kasprzak J, Lewandowski J, Apoznanski W, Dembowski J (2012) Dismembered laparoscopic Anderson–Hynes pyeloplasty versus nondismembered laparoscopic Y–V pyeloplasty in the treatment of patients with primary ureteropelvic junction obstruction: a prospective study. J Endourol 26(9):1165–1170. doi:10.1089/end.2011.0642

    Article  PubMed  Google Scholar 

  21. Erdeljan P, Caumartin Y, Warren J et al (2010) Robot-assisted pyeloplasty: follow-up of first Canadian experience with comparison of outcomes between experienced and trainee surgeons. J Endourol 24(9):1447–1450. doi:10.1089/end.2009.0617

    Article  PubMed  Google Scholar 

  22. Inagaki T, Rha KH, Ong AM, Kavoussi LR, Jarrett TW (2005) Laparoscopic pyeloplasty: current status. BJU Int 95(Suppl 2):102–105. doi:10.1111/j.1464-410X.2005.05208.x

    Article  PubMed  Google Scholar 

  23. Nerli RB, Reddy MN, Jali SM, Hiremath MB (2014) Preliminary experience with laparoscopic Foley’s YV plasty for ureteropelvic junction obstruction in children. J Minim Access Surg 10(2):72–75. doi:10.4103/0972-9941.129953

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hemal AK, Mishra S, Mukharjee S, Suryavanshi M (2008) Robot assisted laparoscopic pyeloplasty in patients of ureteropelvic junction obstruction with previously failed open surgical repair. Int J Urol 15(8):744–746. doi:10.1111/j.1442-2042.2008.02091.x

    Article  PubMed  Google Scholar 

  25. Niver BE, Agalliu I, Bareket R et al (2012) Analysis of robotic-assisted laparoscopic pyleloplasty for primary versus secondary repair in 119 consecutive cases. Urology 79(3):689–694. doi:10.1016/j.urology.2011.10.072

    Article  PubMed  Google Scholar 

  26. Murthy P, Cohn JA, Gundeti MS (2015) Evaluation of robotic-assisted laparoscopic and open pyeloplasty in children: single-surgeon experience. Ann R Coll Surg Engl 97(2):109–114. doi:10.1308/003588414x14055925058797

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Lindgren BW, Frainey BT, Cheng EY, Yerkes EB, Gong EM (2014) Robot assisted laparoscopic pyeloplasty in obese and non-obese patients. J Pediatr Urol. doi:10.1016/j.jpurol.2014.05.013

    Google Scholar 

  28. Kutikov A, Nguyen M, Guzzo T, Canter D, Casale P (2006) Robot assisted pyeloplasty in the infant-lessons learned. J Urol 176(5):2237–2239. doi:10.1016/j.juro.2006.07.059 (discussion 2239–2240)

    Article  PubMed  Google Scholar 

  29. Bansal D, Cost NG, Bean CM et al (2014) Infant robot-assisted laparoscopic upper urinary tract reconstructive surgery. J Pediatr Urol. doi:10.1016/j.jpurol.2014.01.029

    Google Scholar 

  30. Varda BK, Johnson EK, Clark C et al (2014) National trends of perioperative outcomes and costs for open, laparoscopic and robotic pediatric pyeloplasty. J Urol 191(4):1090–1096. doi:10.1016/j.juro.2013.10.077

    Article  PubMed  Google Scholar 

Download references

Authors’ contributions

Kentaro Mizuno was involved in data collection, data analysis, and manuscript writing; Yoshiyuki Kojima was involved in project development and manuscript editing; Satoshi Kurokawa, Hideyuki Kamisawa, Hidenori Nishio, and Yoshinobu Moritoki was involved in data collection; Akihiro Nakane and Tetsuji Maruyama was involved in data analysis; Atsushi Okada and Noriyasu Kawai was involved in data management; Keiichi Tozawa and Kenjiro Kohri was involved in project development; Takahiro Yasui and Yutaro Hayashi was involved in project development and manuscript editing.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yutaro Hayashi.

Ethics declarations

Conflict of interest

Author Kentaro Mizuno, Author Yoshiyuki Kojima, Author Satoshi Kurokawa, Author Hideyuki Kamisawa, Author Hidenori Nishio, Author Yoshinobu Moritoki, Author Akihiro Nakane, Author Tetsuji Maruyama, Author Atsushi Okada, Author Noriyasu Kawai, Author Keiichi Tozawa, Author Kenjiro Kohri, Author Takahiro Yasui, and Author Yutaro Hayashi declare that they have no conflict of interest.

Ethical standards

All procedures described in this article were performed as a clinical trial (No. 46-12-0004) at the Nagoya City University Hospital following institutional review board approval.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mizuno, K., Kojima, Y., Kurokawa, S. et al. Robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction: comparison between pediatric and adult patients-Japanese series. J Robotic Surg 11, 151–157 (2017). https://doi.org/10.1007/s11701-016-0633-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-016-0633-5

Keywords

Navigation