Di Gregorio Marcelo, Botnaru Andrei, Bairy Laurent, Lorge Francis
Urology Department, Cliniques universitaires UCL Dinant-Godinne, Université Catholique de Louvain, 1 Av Gaston Thérasse, Yvoir, Belgium.
Aenesthesia Department, Cliniques universitaires UCL Dinant-Godinne, Université Catholique de Louvain, 1 Av Gaston Thérasse, Yvoir, Belgium.
Springerplus. 2014 Oct 3;3:580. doi: 10.1186/2193-1801-3-580. eCollection 2014.
The treatment of symptomatic uretropelvic junction obstruction (UPJO) has evolved towards minimal invasive endourologic and laparoscopic techniques. Robotic assisted laparoscopic pyeloplasty has achieved outcomes comparable to those corresponding to open and laparoscopic techniques. The objective of this work is to demonstrate that the transition between open to robotic surgeries is straightforward. We analysed retrospectively "our initial results" in robotic assisted UPJ reconstruction procedures. Technical and convalescence aspects for 17 reconstructive robotic procedures performed by 2 surgeons in a 5 years period have been evaluated. Success consisted of no postoperative symptoms, no evidence of obstruction on mercaptoacetyltriglycine-3 diuretic renal scan or computed tomography (CT) and non-further treatment.
mean ± standard deviation, median and range.
From 17 patients who underwent Da Vinci Robot procedure, 15 followed the complete treatment (2 were converted to laparotomy). Two patients had post-operative urine leakage; the stent was changed under sedation without further sequelae. The mean operative time was 189 minutes. The average hospital stay was 4 days. The average follow-up was 25 months. There was only one patient with UPJ stenosis at 6 months and he was treated by balloon dilation. All patients were followed with MAG 3 lasix renal scan, CT or urography. Except the patient with recurrent stenosis, all patients were asymptomatic without objective evidence of obstruction at the present time.
Robotic pyeloplasty technique is feasible and gives good results without previous laparoscopic experience.
有症状的肾盂输尿管连接部梗阻（UPJO）的治疗已朝着微创腔内泌尿外科和腹腔镜技术发展。机器人辅助腹腔镜肾盂成形术已取得与开放手术和腹腔镜手术相当的效果。这项工作的目的是证明从开放手术向机器人手术的过渡是直接的。我们回顾性分析了机器人辅助UPJ重建手术的“初步结果”。评估了两名外科医生在5年期间进行的17例机器人重建手术的技术和康复情况。成功的标准为术后无症状，巯基乙酰三甘氨酸-3利尿肾扫描或计算机断层扫描（CT）无梗阻迹象且无需进一步治疗。
均值±标准差、中位数和范围。
17例行达芬奇机器人手术的患者中，15例完成了治疗（2例转为开腹手术）。2例患者术后出现尿漏；在镇静状态下更换支架，无进一步后遗症。平均手术时间为189分钟。平均住院时间为4天。平均随访时间为25个月。仅1例患者在6个月时出现UPJ狭窄，接受了球囊扩张治疗。所有患者均接受了MAG 3速尿肾扫描、CT或尿路造影检查。除复发性狭窄患者外，目前所有患者均无症状，无梗阻的客观证据。
机器人肾盂成形术技术可行，无需先前的腹腔镜经验即可取得良好效果。
