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World Journal of Urology

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Open Access 01-12-2024 | Pyeloplasty | Topic Paper

Low anterolateral incision for single-port extraperitoneal robot-assisted pyeloplasty: description of technique and initial experience

Authors: Roxana Ramos, Jaya S. Chavali, Ethan Ferguson, Nicolas Soputro, Albert Geskin, Audrey Rhee, Jihad Kaouk

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

This study aims to describe the surgical steps for the single-port low anterolateral extraperitoneal approach to pyeloplasty, report its feasibility, and share the initial outcomes of our experience.

Methods

We analyzed all consecutive patients who underwent single-port low anterolateral extraperitoneal pyeloplasty due to ureteropelvic junction obstruction (UPJO). The surgical steps included a pure single-port approach through a 3.5 cm low anterolateral incision two fingerbreadths above the superior pubic ramus. The ureter was localized and followed cranially, a dismembered pyeloplasty was performed, and a running ureteropelvic anastomosis was completed. No drains were placed. The urinary catheter was removed upon discharge, and the ureteral stent after 3–5 weeks.

Results

A total of eight cases (two adults and six children) were completed successfully, without complications or conversions. Median operative time, console time, and estimated blood loss were 208.5 min, 114.5 min, and 10.0 ml, respectively. All patients were discharged within 24 h, except for one that required urinary output observation due to retention. There were no major postoperative complications. The median pain score at discharge was 0/10. Only one patient was prescribed PRN opioids at discharge. The readmission rate was 0.0%. All patients were asymptomatic on their last follow-up with no definitive obstruction on imaging, and no requirement for additional procedures or stents.

Conclusion

Single-port low anterolateral extraperitoneal pyeloplasty is a feasible alternative for surgical treatment of UPJO in adult and pediatric patients with improved recovery outcomes.

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Title: Low anterolateral incision for single-port extraperitoneal robot-assisted pyeloplasty: description of technique and initial experience
Authors: Roxana Ramos
Jaya S. Chavali
Ethan Ferguson
Nicolas Soputro
Albert Geskin
Audrey Rhee
Jihad Kaouk
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Pyeloplasty
Pyeloplasty
Ureteropelvic Junction Obstruction
Incision
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04915-4

At a glance: The STEP trials

Springer Medicine

Low anterolateral incision for single-port extraperitoneal robot-assisted pyeloplasty: description of technique and initial experience

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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