The ureteropelvic junction is repaired using surgical robotic technology.
What is it?
A robotic pyeloplasty is a minimally invasive, robot-assisted surgery that repairs the ureteropelvic junction of the kidney. The ureteropelvic junction can become blocked and stop urine from passing out of the kidney. As a result, kidneys swell and are damaged, so pyeloplasties are needed in order to repair this through reconstruction between the renal pelvis and ureter. A robotic pyeloplasty differs from a traditional pyeloplasty in that it uses an advanced robotic system controlled by the surgeon that results in less tissue trauma, smaller incisions, and improved visualization and surgical ability. The robotic system has arms with surgical instruments that are controlled by the surgeon in order to create more precise, controlled movements. Typically, patients experience less pain, faster recovery, less bleeding, minimal scarring, and shorter hospital stays with robotic versus traditional pyeloplasties.
How to Prepare
If a patient is having a robotic pyeloplasty, the patient should stop taking blood thinners, aspirin, and nonsteroidal anti-inflammatory medications for one week prior to the surgery. These medications can increase the risk of bleeding during the surgery, which can be a major complication. Patients should check with their physicians before ceasing medications because other medical problems may determine whether or not they should be stopped. The patient should discuss all of his or her current medications with the doctor in order to determine additional measures. A laxative solution will likely be ordered by the doctor in order to clear the intestines and bowels at home prior to the surgery. No food or drink should be taken starting from the midnight prior to the procedure in order to reduce the risk of aspiration, a rare but serious risk that occurs when the stomach’s contents enter the lungs during general anesthesia. The doctor may require a clear liquids diet the night before.
What happens during the procedure?
During a robotic pyeloplasty, the patient is given general anesthesia, which are anesthetic drugs that put the patient to sleep for the duration of the procedure. After anesthesia is administered, the surgeon conducts the procedure entirely behind the robotic console. The surgeon controls the robotic arms and instruments while visualizing the surgery in high definition and real time on the screen that is part of the robotic machine. The video is projected from a small surgical camera that is inserted into one of the small incisions. The surgeon uses the robot to make small incisions through which the instruments are inserted. The incisions are made on the patient’s side where the kidney is, and the renal pelvis is reconstructed with any blockage from the ureteropelvic junction removed.
Risks and Complications
Risks of the surgery include bleeding, infection, damage to the surrounding organs and tissue, continued blockage of the ureter, hernia formation, and leakage of urine. There are also risks associated with general anesthesia such as aspiration.
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