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Patient
Information for Robotic-Assisted Laparoscopic Pyeloplasty
Robotic-assisted laparoscopic pyeloplasty was first reported in 2001. Since that time, robotic
pyeloplasty has become one of the preferred methods for reconstructive surgery for the treatment
of ureteropelvic junction (UPJ) obstruction, or a symptomatic congenital narrowing where the
ureter joins the kidney. Urology Specialists, P.C. is one of  only a few practices in the
region that utilizes the da VinciTM Surgical System
from Intuitive Surgical, Inc.® to perform this procedure. Here is how the operation is
completed:
Laparoscopy is performed by filling the belly with carbon dioxide gas so that a working
space can be created. Small incisions are created through which the instruments are passed. For kidney
reconstruction, 4 small incisions between ¼ and ½ inch are used. The robot holds 2
instruments and the camera. Once the surgeon and his assistant properly set the robot, he then sits
down at a robotic console from where the robotic arms are controlled using hand and foot controls. A
table side assistant surgeon helps by passing instruments and aiding in the dissection.
 This
diagram illustrates the abnormal anatomy of the collecting system in a patient with ureteropelvic
junction (UPJ) obstruction. The narrowing present where the ureter joins the kidney is excised and
the ureter is then carefully reattached to the renal pelvis to reestablish the optimal flow of urine
out of the kidney.
Advantages of Robotic Pyeloplasty
Robotic Pyeloplasty offers the same excellent success rates (over 95%) demonstrated with open
surgery without the larger, more painful incision. Hospital stay is usually overnight for the
robotic procedure compared to 2 to 3 days for the open procedure. Most people can return to work
in 2 to 3 weeks after the robotic procedure while 4 to 6 weeks is usually required after an open
approach.
What to Expect
The usual course experienced by patients undergoing robotic pyeloplasty is as follows: The
patient arrives in the hospital the day of the procedure. The procedure is then performed and
typically takes between 2 and 4 hours depending on the difficulty of dissection. The patient
then spends the first night in the hospital with a small abdominal drain, is given a regular
diet and is encouraged to walk the night of the procedure. Discharge is planned for the next
morning after the drain is removed.
The patient is sent home with a prescription for a
light narcotic oral medication. Many patients do not require this and use only Tylenol or
Ibuprofen. Patients should walk as much as possible immediately. Stair climbing is acceptable.
Patients should refrain from lifting more than 15 pounds for 3 weeks. Some patients do experience
some constipation which can be remedied by Milk of Magnesia or taking Colace pills.
A
ureteral stent is placed during the procedure to maximize healing across the repair. This is
removed in the office or in the operating room 4 to 6 weeks after surgery. Patients are
allowed to drive after one week if they are no longer taking any narcotic medications. Patients
may then return to work within 2 to 3 weeks and then can go back to unrestricted activity in 4
weeks.
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Urology Specialists, P.C. |
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Medical Plaza East: 2529 Glenn Hendren Dr., Suite 202, Liberty, MO 64068 |
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Professional Building North: 2700 Clay Edwards Dr., Suite 300, North Kansas City, MO 64116 |
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