Robot-assisted pyeloplasty

The surgical management for ureteropelvic junction obstruction (UPJ) has evolved over the past few years. We have seen significant changes in the treatment paradigm for this condition. While initially the only treatment option was an open surgical approach, the past few decades have shown an evolution toward less-invasive therapies. Laparoscopic pyeloplasty has evolved and is now considered one of the gold standard treatments for UPJ obstruction with success rates greater than 90%. Endourological procedures (endopyelotomy) have reported success rates between 50% and 88%. The use of the robotic system to perform a pyeloplasty has refined the minimally invasive approach. Delicate tissue handling and precise visualization of suturing are some of the true benefits provided by a robotic system. This chapter discusses in detail the robotic surgical approach to patients with UPJ obstruction. Trocar placement and the definitive surgical steps are described in detail. Postoperative management and outcomes are also discussed.