Salvage minimally invasive robotic and laparoscopic pyeloplasty in adults: a systematic review

Mai Elaarag; Hind Alashi; Maya Aldeeb; Ibrahim Khalil; Ahmad R Al-Qudimat; Abdelhamed Mansour; Abdulla A Al-Ansari; Omar M Aboumarzouk

doi:10.1080/2090598X.2022.2082208

Salvage minimally invasive robotic and laparoscopic pyeloplasty in adults: a systematic review

Arab J Urol. 2022 Jun 28;20(4):204-211. doi: 10.1080/2090598X.2022.2082208. eCollection 2022.

Authors

Mai Elaarag¹, Hind Alashi¹, Maya Aldeeb², Ibrahim Khalil², Ahmad R Al-Qudimat^{1

2}, Abdelhamed Mansour², Abdulla A Al-Ansari^{1

2}, Omar M Aboumarzouk^{1

2

3

4}

Affiliations

¹ Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
² Hamad General Hospital, Hamad Medical Corporation, Qatar, Doha.
³ College of Medicine, Qatar University, Doha, Qatar.
⁴ Dentistry and Nursing, the University of Glasgow, Glasgow, UK.

Abstract

Introduction: A UPJO is a blockage of the ureter that affects urine flow. UPJO is mainly treated by an open approach, however, in recent years minimally invasive techniques are taking place. These techniques include robotic and laparoscopic pyeloplasty. Some patients require a redo after a primary intervention. A systematic review was conducted through the examinations of the efficacy and safety of a robotic redo pyeloplasty in adult patients from previous literature reviews.

Methods: A literature search was made through PubMed. A selection process was done based on our eligibility criteria. The data were represented numerically, listed on tables and analyzed cumulatively using Microsoft Excel.

Results: Twenty studies were included in this review, of which nine were studies on robotic outcomes () (157 patients), 10 on laparoscopic (210 patients), and one review by Zhang et al., focused on both types of surgeries. Two papers (24 patients) from the robotic studies and one paper (21 patients) from the laparoscopic studies were excluded from the intra and post-operative characteristics because not enough data were available and were only included for the success and complication rates. The success rate for the robotic studies was 88.5% while the laparoscopic studies had a success rate of 91%. However, the robotic studies had a complication rate of (11.8%) while the laparoscopic studies had a complication rate of (15.9%). Conversion surgery was required in one patient undergoing laparoscopic surgery.

Conclusion: The minimally invasive methods are becoming more viable in adult patients with rUPJO, considering its effectiveness and fast recovery. This can lead to a new era of robotic assisted surgeries to becoming the gold standard.Abbreviations: Systematic review: Redo robotic and laparoscopic pyeloplasty in adults; UPJO = Ureteropelvic junction obstruction; rUPJO = redo ureteropelvic junction obstruction.

Keywords: Salvage; adults; laparoscopic; pyeloplasty; robotic; secondary.

Publication types

Review

Grants and funding

This review received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.