What question did this study set out to answer?

This research aims to evaluate the perioperative and short-term outcomes of a new robotic surgical technique for ureteropelvic junction obstruction.

June 18, 2026Open Access

Single-port robotic non-transecting Y-V flap pyeloplasty with stricturoplasty for ureteropelvic junction obstruction: a case series

Key Points

This research aims to evaluate the perioperative and short-term outcomes of a new robotic surgical technique for ureteropelvic junction obstruction.
Retrospective review of 21 patients undergoing single-port robotic non-transecting Y-V flap pyeloplasty with stricturoplasty for primary UPJO from December 2020 to December 2024.
Assessment of surgical success based on absence of secondary intervention, symptom resolution, and imaging findings.
Median follow-up duration was 73 weeks.
Overall surgical success rate was 95% with no intraoperative complications.
Median operative time was 109 minutes and estimated blood loss averaged 15 mL.
Postoperative renal scintigraphy in 8 patients showed improved drainage with T½ <20 min.

Abstract

Abstract Purpose To report perioperative and short-term outcomes of single-port (SP) robotic vascular-preserving (non-transecting) Y-V flap pyeloplasty with stricturoplasty for ureteropelvic junction obstruction (UPJO). The most commonly performed pyeloplasty technique is the dismembered Anderson–Hynes technique; however, transection of the ureter compromises its blood supply and makes revision surgery more complex. Non-transecting pyeloplasty preserves the longitudinal ureteral blood supply and serves as an alternative to transecting techniques. Methods All patients who underwent SP robotic-assisted non-transecting Y–V flap pyeloplasty with stricturoplasty for primary UPJO between December 2020 and December 2024 were retrospectively reviewed. Surgical success was defined as the absence of secondary intervention (endoscopic or surgical), resolution or improvement of symptoms, and stable or improved postoperative imaging findings. Results A total of 21 cases met the inclusion criteria. Median operative time was 109 min. Median follow-up was 73 weeks. Overall surgical success was achieved in 95% of patients. There were no intraoperative complications, and the median estimated blood loss was 15 mL. Most patients were discharged the same day (18/21, 86%), with no Clavien–Dindo grade ≥ III complications. Postoperative renal scintigraphy was obtained in 8 patients, all of whom demonstrated improved drainage (T½ <20 min). The remaining patients were followed with clinical assessment and postoperative imaging. One patient developed recurrent obstruction after stent removal and was successfully managed with secondary endopyelotomy. Conclusions SP robotic non-transecting Y-V flap pyeloplasty with stricturoplasty appears feasible and safe in selected patients with primary UPJO, with favorable short-term outcomes in this single-surgeon retrospective series. Further study with standardized functional follow-up is needed to define durability and appropriate patient selection.

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