Laparoscopic or robotic pyeloplasty is a minimally invasive surgical procedure performed to treat strictures at the junction between the renal pelvis and the ureter. The procedure reconstructs this junction to allow urine to flow freely into the ureter and bladder.
Pyeloplasty is the surgical procedure performed for ureteral stenosis, a narrowing of the urethra caused by scar tissue.
This surgical intervention, which consists of correcting this narrowing, has evolved to become less and less aggressive and invasive.
By performing pyeloplasty, the patient can achieve an improvement in urological symptoms and avoid the loss of kidney function or its deterioration.
There are different types of pyeloplasty, the following being the traditional or open surgery This procedure, which involves severing the renal pelvis and the entire ureter to resolve the narrowing, is used less frequently due to its invasive nature. It has a success rate of between 65 and 100 percent.
The next option, and one with a higher success rate, is the laparoscopic pyeloplastyThis procedure offers the advantages of laparoscopic surgery, being a non-invasive procedure that is less aggressive, requires less hospitalization time, and minimizes the risks associated with surgery. The patient's abdomen (distended with gas) is accessed with a camera through small incisions. The narrowed portion is divided, and the healthy ends are joined with absorbable sutures. A catheter is then inserted, which the patient must wear to ensure proper kidney drainage for the next six weeks. This catheter, usually a double-J type, is then removed in the outpatient clinic.
Sometimes, as a consequence of the disease, specialists discover during the intervention that the kidney is severely damaged and it is necessary to perform a nephrectomy (removal of the kidney).
Another, newer option is the robotic pyeloplastyThis procedure benefits from the improvements and advantages of robotic technology. In this case, the Da Vinci robot allows for better manipulation, and the suturing between the renal pelvis and the ureter is performed with greater precision, preventing long-term complications. Similar to laparoscopic surgery, it is performed through small incisions of less than 5 mm, making it not only more aesthetically pleasing for the patient but also reducing the risk of bleeding or infection. The patient will also need to have a catheter in place for about fifteen days, and the hospital stay is, at most, three days.
As we mentioned previously, a nephrectomy is sometimes necessary when a patient's kidney is severely damaged after years of obstruction. In these cases, robotic surgery is the best option, as the precision of its movements allows for better handling of this delicate area.
