Laparoscopic versus robotic pyeloplasty: man versus machine.

With all its different presentations and etiologies, ureteropelvic junction obstruction has been a topic for much research and debate. For several decades, the 'gold standard' of treatment was unequivocally an Anderson-Hynes dismembered pyeloplasty. Various surgical modifications and minimally invasive alternatives have been studied. It was not until the last two decades that laparoscopic and robotic approaches have threatened to supplant the classic open approach as the preferred surgical treatment option. While the debate between the laparoscopic and robotic approaches has been a heavily contested one, it has rarely been founded on prospective, well-matched evidence. We review the existing literature and present our perspective on the clinical, academic and economic aspects of this contest between man and machine.