Nicolò Maria Buffi1, Giovanni Lughezzani2, Rodolfo Hurle2, Massimo Lazzeri2, Gianluigi Taverna3, Giorgio Bozzini3, Riccardo Bertolo4, Enrico Checcucci4, Francesco Porpiglia4, Nicola Fossati5, Giorgio Gandaglia5, Alessandro Larcher6, Nazareno Suardi6, Francesco Montorsi6, Giuliana Lista6, Giorgio Guazzoni2, Alexandre Mottrie7. 1. Department of Urology, Humanitas Clinical and Research Centre, Rozzano, Milan, Italy. Electronic address: buffi.nicolomaria@gmail.com. 2. Department of Urology, Humanitas Clinical and Research Centre, Rozzano, Milan, Italy. 3. Department of Urology, Humanitas Mater Domini, Castellanza, Varese, Italy. 4. San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy. 5. Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium; OLV Vattikuti Robotic Surgery Institute, Melle, Belgium. 6. Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy. 7. Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium; OLV Vattikuti Robotic Surgery Institute, Melle, Belgium.
Abstract
BACKGROUND: Minimally invasive treatment of benign ureteral strictures is still challenging because of its technical complexity. In this context, robot-assisted surgery may overcome the limits of the laparoscopic approach. OBJECTIVE: To evaluate outcomes for robotic ureteral repair in a multi-institutional cohort of patients treated for ureteropelvic junction obstruction and ureteral stricture (US) at four tertiary referral centres. DESIGN, SETTING, AND PARTICIPANTS: This retrospective study reports data for 183 patients treated with standard robot-assisted pyeloplasty (PYP) and robotic uretero-ureterostomy (UUY) at four high-volume centres from January 2006 to September 2014. SURGICAL PROCEDURE: Robotic PYP and robot-assisted UUY were performed according to previously reported surgical techniques. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Preoperative, intraoperative, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: No robot-assisted UUY cases required surgical conversion, while 2.8% of PYP cases were not completed robotically. The median operative time was 120 and 150min for robot-assisted PYP and robot-assisted UUY, respectively. No intraoperative complications were reported. The overall complication rate for all procedures was 11% (n=20) and complications were mostly of low grade. The high-grade complication rate was 2.2% (n=4). At median follow-up of 24 mo, the overall success rate was >90% for both procedures. The study limitations include its retrospective nature and the heterogeneity of the study population. CONCLUSIONS: Robotic surgery for benign US is safe and effective, with limited risk of high-grade complications and good intermediate-term results. PATIENT SUMMARY: In this study we review the use of robotic surgery at four different tertiary care centres in the treatment of patients affected by benign ureteral strictures. Our results demonstrate that robotic surgery is a safe alternative to the standard open approach in the treatment of ureteral strictures.
BACKGROUND: Minimally invasive treatment of benign ureteral strictures is still challenging because of its technical complexity. In this context, robot-assisted surgery may overcome the limits of the laparoscopic approach. OBJECTIVE: To evaluate outcomes for robotic ureteral repair in a multi-institutional cohort of patients treated for ureteropelvic junction obstruction and ureteral stricture (US) at four tertiary referral centres. DESIGN, SETTING, AND PARTICIPANTS: This retrospective study reports data for 183 patients treated with standard robot-assisted pyeloplasty (PYP) and robotic uretero-ureterostomy (UUY) at four high-volume centres from January 2006 to September 2014. SURGICAL PROCEDURE: Robotic PYP and robot-assisted UUY were performed according to previously reported surgical techniques. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Preoperative, intraoperative, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: No robot-assisted UUY cases required surgical conversion, while 2.8% of PYP cases were not completed robotically. The median operative time was 120 and 150min for robot-assisted PYP and robot-assisted UUY, respectively. No intraoperative complications were reported. The overall complication rate for all procedures was 11% (n=20) and complications were mostly of low grade. The high-grade complication rate was 2.2% (n=4). At median follow-up of 24 mo, the overall success rate was >90% for both procedures. The study limitations include its retrospective nature and the heterogeneity of the study population. CONCLUSIONS: Robotic surgery for benign US is safe and effective, with limited risk of high-grade complications and good intermediate-term results. PATIENT SUMMARY: In this study we review the use of robotic surgery at four different tertiary care centres in the treatment of patients affected by benign ureteral strictures. Our results demonstrate that robotic surgery is a safe alternative to the standard open approach in the treatment of ureteral strictures.
Authors: Ziho Lee; Matthew E Sterling; Aryeh Y Keehn; Matthew Lee; Michael J Metro; Daniel D Eun Journal: World J Urol Date: 2018-09-18 Impact factor: 4.226
Authors: Matthew Lee; Ziho Lee; Helaine Koster; Minsuk Jun; Aeen M Asghar; Randall Lee; David Strauss; Neel Patel; Daniel Kim; Sreeya Komaravolu; Alice Drain; Michael J Metro; Lee Zhao; Michael Stifelman; Daniel D Eun Journal: Investig Clin Urol Date: 2020-11-12
Authors: Shengwei Xiong; Jie Wang; Weijie Zhu; Kunlin Yang; Guangpu Ding; Xuesong Li; Daniel D Eun Journal: Biomed Res Int Date: 2020-07-27 Impact factor: 3.411