Robot-assisted laparoscopic upper urinary tract reconstruction surgery: A review of 108 cases by a single surgeon / 北京大学学报(医学版)

ABSTRACT

OBJECTIVE@#To summarize the experiences and outcomes of 108 robot-assisted laparoscopic upper urinary tract reconstruction surgeries conducted by a single surgeon.@*METHODS@#We consecutively and retrospectively reviewed 108 patients who underwent robot-assisted laparoscopic upper urinary tract reconstruction surgeries by a single surgeon from November 2018 to January 2020. The patient demographics, perioperative variables, postoperative complications and follow-up data were recorded. Fifty-three modified dismembered pyeloplasties (MDP), 11 spiral flap pyeloplasties (SFP), 11 ure-teroureterostomies (UUT), 4 lingual mucosal onlay graft ureteroplasties (LMU), 5 appendiceal onlay flap ureteroplasties (AU), 11 ureteral reimplantations (UR), 6 Boari flap-Psoas hitch surgeries (BPS) and 7 ileal ureter replacements (IUR) were enrolled finally. The success was defined as the improvement in subjective pain levels, and the improvement in the degree of hydronephrosis at ultrasound.@*RESULTS@#All the surgeries were successfully completed without open or laparoscopic conversion. The median operative time was 141 min (range 74-368 min), median blood loss was 20 mL (range 10-350 mL) and median hospital stay was 4 d (range 3-19 d) in MDP group, with the success rate of 94.3%. The median operative time was 159 min (range 110-222 min), median blood loss was 50 mL (range 20-150 mL) and median hospital stay was 5 d (range 3-8 d) in SFP group, with the success rate of 100%. The median operative time was 126 min (range 76-160 d), median blood loss was 20 mL (range 10-50 mL) and median hospital stay was 5 d (range 4-9 d) in UUT group, with the success rate of 100%. The median operative time was 204 min (range 154-250 min), median blood loss was 30 mL (range 10-100 mL) and median hospital stay was 6 d (range 4-7 d) in LMU group, with the success rate of 100%. The median operative time was 164 min (range 135-211 min), median blood loss was 75 mL (range 50-200 mL) and median hospital stay was 8.5 d (range 6-12 d) in AU group, with the success rate of 100%. The median operative time was 149 min (range 100-218 min), median blood loss was 20 mL (range 10-50 mL) and median hospital stay was 7 d (range 5-10 d) in UR group, with the success rate of 90.9%. The median operative time was 166 min (range 137-205 min), median blood loss was 45 mL (range 20-100 mL) and median hospital stay was 5 d (range 4-41 d) in BPS group, with the success rate of 83.3%. The median operative time was 270 min (range 227-335 min), median blood loss was 100 mL (range 10-100 mL) and median hospital stay was 7 d (range 5-26 d) in IUR group, with the success rate of 85.7%.@*CONCLUSIONS@#The surgeon performed and modified numerous complicated upper urinary tract reconstruction surgeries by the robotic platform, which facilitated the development of the standardized upper urinary tract reconstruction surgical technique.