Work

Comparison of long-term outcomes and costs of robot-assisted versus laparoscopic pyeloplasty for ureteropelvic junction obstruction: A single-surgeon cohort study

Year: 2025

Type: article

Abstract: Objective Ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis requiring surgical intervention. While robot-assisted pyeloplasty (RAP) and laparoscopic pyeloplasty (LP) are established minimally invasive techniques, single-surgeon comparative studies focusing on the long-term outcomes and costs remain limited. We aim to present our experience with both RAP and LP from an experienced single surgeon. Methods Between March 2010 and December 2023, 37 patients with UPJO who underwent RAP or LP by a single surgeon at a tertiary center were included in this retrospective cohort study. Patient characteristics, perioperative and long-term outcomes, complications, and costs were evaluated. Results Among 37 patients, 17 patients received RAP and 20 patients received LP. Median ages were 38.9 years (RAP) and 19.8 (LP; p = 0.094). Median operative times were 175.0 min (RAP) and 208.5 min (LP; p = 0.140). The median hospital stays were 6 days for both group (p = 0.430). No Clavien-Dindo class III or higher complication occurred. After a median follow-up exceeding 5 years, both cohorts demonstrated comparable long-term success rates at 100 % for RAP and 95.0 % for LP (p = 0.357). Median total costs were significantly higher for RAP (9187.41 USD vs 5576.34 USD, p < 0.001). Conclusion RAP and LP are effective and safe approaches for the management of UPJO, offering comparable long-term success and perioperative outcomes when performed by an experienced surgeon. However, the significantly higher cost of RAP warrants consideration. Our findings emphasize the importance of surgeon expertise and patient-specific factors in surgical decision-making.

Source: Asian Journal of Surgery

DOI: 10.1016/j.asjsur.2025.10.133

Authors: Tsung-Yi Hsieh, Hsiao-Yu Chang, Shin Mei Wong, Shang-Jen Chang, Kuo-How Huang

Institutions: National Taiwan University, National Taiwan University Hospital

Language: English

Topic: Pediatric Urology and Nephrology Studies

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,200