Through the comparison with laparoscopic pyeloplasty, this paper discusses the clinical value of robot assisted laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction (UPJO). 82 patients with UPJO admitted to the First Affiliated Hospital of Medical College of Zhejiang University from January 2012 to December 2018 were retrospectively analyzed, including 43 patients who underwent robot assisted laparoscopic pyeloplasty (RALP group); Laparoscopic pyeloplasty was performed in 39 cases (LP group). The operation time, reconstruction suture time, intraoperative bleeding, postoperative drainage, postoperative intestinal recovery time, postoperative hospitalization time, hospitalization expenses, surgical complications and follow-up were compared and analyzed between the two groups. There was no significant difference between the two groups in operation time, renal pelvis reconstruction time, intraoperative bleeding, postoperative drainage tube stopping time, postoperative drainage volume and intestinal recovery time (P > 0.05); and the postoperative indwelling time of urinary catheter and postoperative hospital stay in RALP group were shorter than those in LP group (P < 0.05); The hospitalization cost in RALP group was significantly higher than that in LP group. Clavien Grade II complications occurred in 8 cases in LP group, Clavien Grade II complications occurred in 2 cases in RALP group, and there was 1 case of Grade III complications in both groups. The complication rate was 6.79% in RALP group and 23.07% in LP group. There was significant difference between the two groups (P < 0.05). During the postoperative follow-up, hydronephrosis was aggravated in 1 patient in RALP group half a year after operation, and hydronephrosis was aggravated in 1 patient in LP group due to ureteral stone obstruction. Another patient in LP group was found to have more hydronephrosis than before. The success rate was 97.7% in RALP group and 94.8% in LP group. There was no significant difference between the two groups (P > 0.05). Compared with laparoscopy, robot assisted laparoscopic pyeloplasty is a better surgical option. With the reduction of cost, it will gradually replace laparoscopic pyeloplasty.

Qi Xu, Ping Wang, Jie Qin, Shuo Wang, Dan Xia, Jianfei Zhan, Xiangyi Zheng. Comparative Analysis of Robot Assisted Laparoscopy and Laparoscopic Pyeloplasty in the Treatment of Ureteropelvic Junction Obstruction. Frontiers in Medical Science Research (2022) Vol. 4, Issue 1: 5-11. https://doi.org/10.25236/FMSR.2022.040102.

[1]Anderson JC,Hynes W. Retrocaval ureter: a case diagnosed preoperatively and treated successfully by a plastic operation[J].Br J Urol,1949,21(3):209-214.

[2] Radmayr C, Bogaert G, Dogan HS, et al. EAU Guidelines on paediatric urology, Edn. Presented at the EAU Annual Congress Barcelona, 2019, ISBN 978-94-92671-04-02.

[3] Dindo D, Demartines N, Clavien PA. Classification of surgical complications：A new proposal with evaluation in a cohoa of 6 336 patients and results of a survey [J]. Ann Surg, 2004, 240(2): 205-213.

[4] Jens R, Jan K, Serdar GA. Retroperitoneal laparoscopic non-dismembered pyeloplasty for uretero-pelvic junction obstruction due to crossing vessels: A matched-paired analysis and review of literature [J]. Asian J Urol, 2018, 5(3):172-181.

[5] Hong P, Ding G,Zhu D,et al. Head-to-Head Comparison of Modified Laparoscopic Pyeloplasty and Robot-Assisted Pyeloplasty for Ureteropelvic Junction Obstruction in China[J]. Urol Int, 2018, 101(3):337–344.

[6] Wang P,Xia D,Ma Q,et al. Retroperitoneal Laparoscopic Management of Ureteropelvic Junction Obstruction in Patients With Horseshoe Kidney[J].Urology,2014,84(6):1351-1354.

[7] Tam YH, Pang KKY,Wong YS,et al. From Laparoscopic Pyeloplasty to Robot-Assisted Laparoscopic Pyeloplasty in Primary and Reoperative Repairs for Ureteropelvic Junction Obstruction in Children [J]. Laparoendosc Adv Surg Tech A, 2018, 28(8):1012-1018.

[8] Varda BK, Wang Y, Chung BI, et al. Has the robot caught up? National trends in utilization, perioperative outcomes, and cost for open, laparoscopic, and robotic pediatric pyeloplasty in the United States from 2003 to 2015[J]. Pediatr Urol, 2018, 14(4):336.

[9] Khoder WY, Waidelich R, Ghamdi AMA, et al. A prospective rando mised comparison between the transperitoneal and retroperitoneo scopic approaches for robotic‐assisted pyeloplasty in a single surgeon, single centre study [J]. Robot Surg. 2018; 12(1):131‐137.

[10] Light A, Karthikeyan S, Maruthan S, et al. Peri-operative outcomes and complications after laparoscopic vs robot-assisted dismembered pyeloplasty: a systematic review and meta-analysis [J]. Journal of Robotic Surgery, 2018, 12(3):581-602.

[11] Riachy E,Cost NG,Defoor WR, et al. Pediatric standard and robot-assisted laparoscopic pyeloplasty: a comparative single institution study[J].J Urol,2013,189(1):283-287.

[12] Silay MS, pinoit AF,Undre S, et al. Global minimally invasive pyeloplasty study in children: results from the Pediatric Urology Expert Group of the European Association of Urology Young Academic Urologists working party[J]. J Pediatr Urol, 2016, 12(4):229.e1-e7.