Robot-Assisted Kidney Blockage Surgery Offers Several Advantages

A new study comparing two types of minimally invasive surgery to repair uretero-pelvic junction (UPJ) obstructions has found that robot-assisted laparoscopic surgery was faster and resulted in less blood loss and shorter hospital stays than standard laparoscopic surgery.

Researchers at Wake Forest University Baptist Medical Center (Winston-Salem, NC, USA) and the All India Institute of Medical Sciences (New Delhi, India) followed 60 patients who underwent pyeloplasty--a procedure that involves reconstructing the UPJ--for 18 months and compared the results of laparoscopic pyeloplasty (LP) and robot-assisted pyeloplasty (RP) surgery for repairing the kidney blockage. Half of the patients were treated with standard laparoscopic surgery and the other half underwent robot-assisted surgery.

The results showed that both options were equally successful, but the robot-assisted technique had several advantages. On average, robot-assisted surgery was 50% faster (98 minutes versus 145-minute average), resulted in 60% less blood loss (40 mL compared to 101 mL average), and required a 2-day hospital stay compared to 3.5 days for laparoscopic surgery. Compared to pure LP, pure RP enabled the surgeon to achieve quicker dissection, reconstruction, and intracorporeal suturing with fine sutures and with antegrade double-J stenting. With RP, the operating time was decreased, and the procedure offered greater ergonomic convenience to the surgeon. The study was published the February 2010 issue of the Canadian Journal of Urology.

"This was one of the first studies where a single surgeon at one center performed both types of surgery and compared the results,” said lead author Ashok Hemal, M.D., director of the robotic and minimally invasive urologic surgery program at Wake Forest Baptist, who performed all of the surgeries. "It allows for a more accurate comparison of surgical options than multiple physicians performing the surgeries. The results showed that robot-assisted surgery had significant advantages for this condition. It is also generally easier for surgeons to learn.”

Blockages in the UPJ area prevent urine from draining normally to the bladder and can cause inflammation of the upper urinary tract. The blockage can be the result of birth defects or, in adults, from injury, previous surgery, or other disorders.

Related Links:
Wake Forest University Baptist Medical Center
All India Institute of Medical Sciences