Abstract Objective The objective of this study is to evaluate the outcomes of an initial series of single‐port robot‐assisted ureterolysis (SP‐RAU) in patients with retroperitoneal fibrosis (RPF). Patients and Methods We prospectively collected surgical and clinical data from all consecutive patients undergoing SP‐RAU at our institution between April 2016 and May 2024. The primary endpoint was the achievement of a stent‐free status at 12 months. Results Overall, 16 patients (21 renal units) underwent SP‐RAU with a minimum follow‐up of 12 months. All five patients with bilateral disease were managed with a staged approach in two separate surgical sessions. RPF was idiopathic in 37% and secondary in 62% of cases. Four procedures (19%) were aborted due to extensive fibrosis or high vascular risk (one unilateral right, two unilateral left and one second‐stage left unit). These patients had significantly longer preoperative stent duration (60 vs. 9 months; p = 0.006). Among the 17 completed procedures, no open conversions, intraoperative complications or transfusions occurred. Median operative time was 215 min (IQR 195–240), and median blood loss was 10 ml (IQR 10–20). Median length of stay was 11.5 h (IQR 7.8–26), with 52% of patients discharged the same day. At a median follow‐up of 25 months (IQR 18–50), complete symptom resolution was achieved in 82% of renal units, whereas 64% remained stent‐free at 12 months. The main limitations are the small sample size, single‐surgeon experience and absence of a comparator arm. Conclusion SP‐RAU is a safe and feasible minimally invasive option for managing RPF. It achieves good functional success with minimal morbidity and enables same‐day discharge in over half of patients. Larger multicentre studies with longer follow‐up are needed to confirm these findings and establish the role of SP‐RAU in the management of RPF.
Carletti et al. (Fri,) studied this question.