TY - JOUR
T1 - Robot-assisted, single-site, dismembered pyeloplasty for ureteropelvic junction obstruction with the New da Vinci Platform
T2 - A stage 2a study
AU - Buffi, Nicolò Maria
AU - Lughezzani, Giovanni
AU - Fossati, Nicola
AU - Lazzeri, Massimo
AU - Guazzoni, Giorgio
AU - Lista, Giuliana
AU - Larcher, Alessandro
AU - Abrate, Alberto
AU - Fiori, Cristian
AU - Cestari, Andrea
AU - Porpiglia, Francesco
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background Laparoendoscopic single-site surgery (LESS) has gained popularity in urology over the last few years. Objective To report a stage 2a study of robot-assisted single-site (R-LESS) pyeloplasty for ureteropelvic junction obstruction (UPJO). Design, setting, and participants This study is an investigative pilot study of 30 consecutive cases of R-LESS pyeloplasty performed at two participating institutions between July 2011 and September 2013. Surgical procedure Dismembered R-LESS pyeloplasty was performed at two surgical centers. Measurements Feasibility (conversion rate), safety (complication rate and Clavien-Dindo classification), efficacy (clinical outcome) of the procedure were assessed. Results and limitations The median patient age was 37 yr (range: 19-65 yr) and median body mass index was 23 kg/m2 (range: 19-29 kg/m2). The median operative time was 160 min (range: 101-300 min), the median postoperative stay was 5 d (range: 3-13 d), and the median time to catheter removal was 3 d (range: 2-10). Two cases required conversion, the first one to standard laparoscopic technique and the second one to standard robotic technique. No intraoperative complications were reported. In three cases, an additional 5-mm trocar was needed. The postoperative complications rate was 26% (n = 8). Most of them were grade 1 complications (n = 4; 13%), followed by grade 2 (n = 3; 10%) and grade 3 (n = 1; 3.3%) complications, according to the Clavien-Dindo classification. One patient needed a surgical reintervention with standard robotic technique 3 d after surgery for urinary leakage. The overall success rate, considered as the resolution of symptoms and the absence of functional impairment at postoperative imaging, was 93.3% (n = 28) at a median follow-up of 13 mo (range: 3-21 mo). The main limitations of this study are the limited number of patients included and the short-term follow-up. Conclusions Single-site robotic pyeloplasty is a feasible technique in selected patients, with good cosmetic results and excellent short-term clinical outcomes. Prospective studies are needed to further assess its role for the treatment of UPJO. Patient summary Single-site robot-assisted pyeloplasty is a feasible technique with good cosmetic results and excellent short-term clinical outcomes.
AB - Background Laparoendoscopic single-site surgery (LESS) has gained popularity in urology over the last few years. Objective To report a stage 2a study of robot-assisted single-site (R-LESS) pyeloplasty for ureteropelvic junction obstruction (UPJO). Design, setting, and participants This study is an investigative pilot study of 30 consecutive cases of R-LESS pyeloplasty performed at two participating institutions between July 2011 and September 2013. Surgical procedure Dismembered R-LESS pyeloplasty was performed at two surgical centers. Measurements Feasibility (conversion rate), safety (complication rate and Clavien-Dindo classification), efficacy (clinical outcome) of the procedure were assessed. Results and limitations The median patient age was 37 yr (range: 19-65 yr) and median body mass index was 23 kg/m2 (range: 19-29 kg/m2). The median operative time was 160 min (range: 101-300 min), the median postoperative stay was 5 d (range: 3-13 d), and the median time to catheter removal was 3 d (range: 2-10). Two cases required conversion, the first one to standard laparoscopic technique and the second one to standard robotic technique. No intraoperative complications were reported. In three cases, an additional 5-mm trocar was needed. The postoperative complications rate was 26% (n = 8). Most of them were grade 1 complications (n = 4; 13%), followed by grade 2 (n = 3; 10%) and grade 3 (n = 1; 3.3%) complications, according to the Clavien-Dindo classification. One patient needed a surgical reintervention with standard robotic technique 3 d after surgery for urinary leakage. The overall success rate, considered as the resolution of symptoms and the absence of functional impairment at postoperative imaging, was 93.3% (n = 28) at a median follow-up of 13 mo (range: 3-21 mo). The main limitations of this study are the limited number of patients included and the short-term follow-up. Conclusions Single-site robotic pyeloplasty is a feasible technique in selected patients, with good cosmetic results and excellent short-term clinical outcomes. Prospective studies are needed to further assess its role for the treatment of UPJO. Patient summary Single-site robot-assisted pyeloplasty is a feasible technique with good cosmetic results and excellent short-term clinical outcomes.
KW - Pyeloplasty
KW - Robotic surgery
KW - Single site
KW - Ureteropelvic junction obstruction
UR - http://www.scopus.com/inward/record.url?scp=84924416890&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924416890&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2014.03.001
DO - 10.1016/j.eururo.2014.03.001
M3 - Article
C2 - 24656756
AN - SCOPUS:84924416890
VL - 67
SP - 151
EP - 156
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 1
ER -