Int J Med Robot - Robotic Anderson-Hynes dismembered pyeloplasty: initial experience.

Tópicos

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Resumo

TRODUCTION: The introduction of the da Vinci(?) robotic system in 2000 has been a new step forward in the treatment of ureteropelvic junction obstruction (UPJO). The aim of this study was to analyse our initial experience with robot-assisted dismembered Anderson-Hynes pyeloplasty and to perform a bibliographic review on the topic.PATIENTS AND METHODS: We performed 11 robot-assisted pyeloplasties between March 2007 and April 2011. UPJO diagnosis was made on clinical presentation and imaging techniques (CT scan and intravenous urography). All patients underwent basal and diuretic isotopic renograms to evaluate the degree of obstruction and impaired renal function. Median follow-up was 10 (range 1-26) months.RESULTS: Mean patient age was 38.8 (range 23-62) years. There were six women (55%) and five men (45%). All cases were primary surgeries. In four patients the cause of UPJO was a crossing vessel; the other seven patients had intrinsic obstruction. One case was associated with extraction of a calyceal lithiasis. Mean operative time was 189.4min (125-270min). Average time from robotic arms docking was 116.5 (range 55-180) min. Average hospital stay was 4.18 (range 2-8) days. Conversion to open or laparoscopic surgery was not necessary in any case and there were no postoperative complications. Postoperative radiological evaluation and renograms showed good results in all cases.CONCLUSIONS: Robotic surgery offers better ergonomics, enhanced three-dimensional (3D) vision and more precise movements, easing intracorporeal suturing.These advantages make robotic pyeloplasty a reproducible technique that combines the high success rates of open surgery and the benefits of laparoscopic surgery.

Resumo Limpo

troduct introduct da vinci robot system new step forward treatment ureteropelv junction obstruct upjo aim studi analys initi experi robotassist dismemb andersonhyn pyeloplasti perform bibliograph review topicpati method perform robotassist pyeloplasti march april upjo diagnosi made clinic present imag techniqu ct scan intraven urographi patient underw basal diuret isotop renogram evalu degre obstruct impair renal function median followup rang monthsresult mean patient age rang year six women five men case primari surgeri four patient caus upjo cross vessel seven patient intrins obstruct one case associ extract calyc lithiasi mean oper time min min averag time robot arm dock rang min averag hospit stay rang day convers open laparoscop surgeri necessari case postop complic postop radiolog evalu renogram show good result casesconclus robot surgeri offer better ergonom enhanc threedimension d vision precis movement eas intracorpor suturingthes advantag make robot pyeloplasti reproduc techniqu combin high success rate open surgeri benefit laparoscop surgeri

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