Robotic pyeloplasty is a surgical intervention utilized for the treatment of ureteropelvic junction (UPJ) obstruction, a condition where the connection between the renal pelvis and the proximal ureter, known as the UPJ, becomes blocked. This obstruction restricts or halts the flow of urine, leading to its accumulation and potential damage to the kidney. Symptoms can include abdominal discomfort, kidney stones, and compromised kidney function.
About UPJ Obstruction
UPJ obstruction can arise from congenital factors or acquired conditions such as intrinsic stenosis, high ureteral insertion with kinks, malignant neoplasms, ureteral valves, iatrogenic injury, lower pole accessory vessel, benign neoplasms, adhesive bands, vesicoureteral reflux, and inflammation with scarring.
Common symptoms of UPJ obstruction include abdominal pain, nausea, vomiting, intermittent pain, ipsilateral flank pain, elevated serum creatinine levels, gastrointestinal issues, kidney stone formation, reduced renal function, urinary tract infections, hydronephrosis, and delayed drainage from the kidney.
Detecting UPJ obstruction often involves a thorough examination of the patient’s medical history and a physical assessment by the physician. Inquiries may explore past occurrences of urinary tract infections, instances of blood in the urine (hematuria), or kidney stones (nephrolithiasis). Both functional and anatomical evaluations are conducted to provide a comprehensive understanding of the condition. Based on the diagnosis, patients may be recommended for robotic pyeloplasty.
Robotic pyeloplasty offers several advantages, including reduced scarring, accelerated recovery, and reduced postoperative pain compared to alternative surgical methods.
What to Expect During Robotic Pyeloplasty
During robotic pyeloplasty, a minimally invasive approach is employed to eliminate the UPJ obstruction. Carbon dioxide gas is used to inflate the abdominal cavity, enabling the insertion of laparoscopic instruments through ports. The surgeon then utilizes these instruments to access the affected kidney, excise the obstruction, and reconstruct the urinary tract to rectify any ureteral or renal damage. Typically lasting around three hours, the procedure aims to restore normal kidney function and alleviate symptoms associated with UPJ obstruction.
The potential risks associated with robotic pyeloplasty will be outlined by the physician prior to the procedure. These risks may include increased bleeding, infection, scarring, hernia formation, blood clots, and inadvertent damage to neighboring organs, including the intestines, stomach, blood vessels, liver, spleen, pancreas, ovaries, Fallopian tubes, and bladder.
Recovery Process
Following surgery, patients typically remain hospitalized for one to two days. They are allowed to resume eating and drinking within a few hours post-operation. While encouraged to engage in light activity, strenuous exertion should be avoided. Intravenous antibiotics are administered, and the urinary or Foley catheter is managed by nursing staff. Some patients may have a double-J catheter or percutaneous nephrostomy tube in place to facilitate ureteral healing.
In the days following the procedure, patients may experience discomfort due to ureteral swelling, which can be managed with oral or intravenous pain medication. Additionally, bladder spasms may occur, attributed to irritation from catheters and other inserted tubes.
To learn more about robotic pyeloplasty and to schedule a consultation, contact UCI Pelvic Health Center.