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Robotic Pyeloplasty
Da Vinci Robotic Pyeloplasty (also known as Robotic Assisted Pyeloplasty) is the most advanced method of performing laparoscopic pyeloplasty. This minimally invasive procedure coined its name from the Da Vinci© Robot, which is manufactured by “Intuitive Surgical”. Pyelolasty is a surgical reconstruction of the renal pelvis (the area in the kidney where the urine collects) to treat ureteropelvic junction obstruction (UPJO).
The Robot combines the latest achievements in medical technology and laparoscopy including:
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Surgeon’s console and patient side cart
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High-performance InSite® Vision System
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Proprietary EndoWrist® Instruments
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- Ergonomically designed surgeon’s console
While sitting comfortably at the console, the surgeon operates while viewing a 3-D color image of the surgical field.
- Patient-side cart with four interactive robotic arms
(three instrument arms and one endoscope arm)
Endowrist instruments execute the surgeon's commands through the key-hole port sites in the patient's abdomen. Surgical team members assist the surgeon by properly installing the Endowrist instruments.
- High-performance InSite® Vision System
with high-resolution 3-D endoscope provides real-time 3-D images of the operative field, with magnification of 12-15 times. This advanced technology spares nerves and delicate tissues during the operation, which plays an important role in patients’ fast recovery and maintenance of the patients' sexual and urinary function.
- Proprietary EndoWrist® Instruments
The instruments are designed with seven degrees of motion that mimic the movements of the human hand and wrist. All movements of the surgeon hands are translated into precise movements with micro-instruments.
Uretero pelvic junction obstruction (UPJO) is a blockage of the kidney where the renal pelvis drains into the ureter (the tube that carries urine from the kidney to the bladder). Such a blockage can cause pain, kidney stones, infection, and renal failure. Sometimes dilation in the renal pelvis seen on an x-ray looks like a blockage but does not cause pain, kidney stones, infections, or renal failure. Such a “UPJO” does not need to be treated, but if a UPJO does cause pain, stones, infections, or renal failure, it should be considered for treatment.
Robotic Pyeloplasty is clearly the most definitive surgical treatment with the fewest side effects for treaty UPJO. There are other treatment but for various reasons they are inferior to Robotic Pyeloplasty. Open Pyeloplasty through a large flank incision (an incision under the ribs in your side) involves significantly more pain and a much longer convalescence and does not have higher success rates. Less invasive endoscopic (telescopes though the bladder into the ureter) have lower success rates but not less side effects. For these reasons, in most cases of symptomatic UPJO, the first treatment to consider is robotic pyeloplasty. Robotic pyeloplasty involves 5-6 small keyhole incisions about the size of a fingernail. Most patients stay overnight or perhaps two nights in the hospital. A plastic tube, called a stent, is left in the kidney/ureter/bladder to allow for healing. You will need to have this stent removed about one month after surgery. Removal of the stent will require placing a telescope (cystoscopy) into your bladder. There may also be a drain in your abdomen for 1-3 days after robotic pyeloplasty.
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