Robotic-assisted pyeloplasty:recent developments in efficacy, outcomes, and new techniques.

Within the last decade, the adaptation of robotic urologic surgery has had a profound impact on surgical practice, with robotic upper tract reconstruction for ureteropelvic junction obstruction gaining rapid acceptance. Recent advances in robotic reconstruction demonstrate efficacious outcomes of robotic pyeloplasty, as compared with conventional laparoscopic pyeloplasty, even in the case of secondary surgery. Furthermore, efforts to continue to reduce the morbidity of laparoscopic surgery have led to the development and implementation of laparoendoscopic single-site (LESS) surgery. The recent applications of the da Vinci robotic surgical platform to LESS pyeloplasty (R-LESS) has demonstrated the potential to further decrease morbidity, improve surgeon ergonomics, and improve cosmesis.