Preliminary experience of applying robotic-assisted laparoscopic pyeloplasty for bilateral ureteropelvic junction obstructions in children

Objective To summarize the experience and efficacy of robot-assisted bilateral laparoscopic pyeloplasty for children with bilateral ureteropelvic junction obstruction (UPJO). Methods Robot-assisted bilateral laparoscopic pyeloplasty was performed for 6 children with bilateral severe hydronephrosis from June 2017 to May 2019. There were 4 boys and 2 girls with an average age of (65.8±34.2) months. Ultrasound, magnetic resonance urography (MRU), diuretic renal dynamic imaging and voiding cystourethrogram (VCUG) were performed. The left/right-side preoperative anterioposterior diameter (APD) was (3.07±0.67) and (3.22±0.51) cm respectively. Then robotic-assisted bilateral laparoscopic pyeloplasty was performed. Results All operations were successful. There was no intraoperative complication. The mean operative duration was (246.17±23.02) min and the mean volume of estimated blood loss was(29.17±6.07) ml. No complications of Clavien-Dindo grade Ⅲ/Ⅳ occurred. The mean follow-up period was (16.5±8.92) months. The left/right-side postoperative APD was (1.37±0.25) and (1.47±0.19) cm respectively. The statistical difference was significant. All renal functions were normal. Conclusions Robotic-assisted bilateral laparoscopy pyeloplasty is both feasible and safe. It provides an effective method of managing patients with bilateral UPJO.