Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction

Objective:A surge in the easy availability of robotic platforms has resulted in numerous surgical procedures, which were previously done using an open or conventional laparoscopic approach, are now being done using robots worldwide. A prospective randomized study was conducted to compare surgical an...

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Main Authors: Aditya Abhishek Jha, Arjun Singh Sandhu, Sharat Chandra Dash, Raghav Talwar, Madhu Govindaiah, Gagandeep Singh, Anoop Handa, Nimit Solanki
Format: Article
Language:English
Published: Galenos Yayinevi 2022-03-01
Series:Journal of Urological Surgery
Subjects:
Online Access: http://jurolsurgery.org/archives/archive-detail/article-preview/comparison-of-surgical-and-functional-outcome-of-l/51023
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author Aditya Abhishek Jha
Arjun Singh Sandhu
Sharat Chandra Dash
Raghav Talwar
Madhu Govindaiah
Gagandeep Singh
Anoop Handa
Nimit Solanki
author_facet Aditya Abhishek Jha
Arjun Singh Sandhu
Sharat Chandra Dash
Raghav Talwar
Madhu Govindaiah
Gagandeep Singh
Anoop Handa
Nimit Solanki
author_sort Aditya Abhishek Jha
collection DOAJ
description Objective:A surge in the easy availability of robotic platforms has resulted in numerous surgical procedures, which were previously done using an open or conventional laparoscopic approach, are now being done using robots worldwide. A prospective randomized study was conducted to compare surgical and functional outcomes of conventional laparoscopic pyeloplasty with robotic-assisted pyeloplasty.Materials and Methods:Patients who require pyeloplasty who presented to our institute between June 2015 and March 2018 were randomized into a robot-assisted or conventional laparoscopic pyeloplasty group. Common steps included a lateral trans-peritoneal approach, intraoperative antegrade double-J stent placement, stent removal at 4 weeks postoperative, and Diethylene Triamine Penta Acetate renogram at 4 weeks post stent removal. Records of intraoperative and postoperative variables were maintained for all patients. The comparison of continuous numerical data was done using the Independent t-test and categorical non-numerical data using the chi-square (χ2) test. P-values of <0.05 were considered significant.Results:This study includes 58 patients who were randomized into two groups with 29 patients each. No significant difference was noted for postoperative variables, such as the visual analog score for pain, drain placement duration, hospitalization duration, and time to return to daily activity. Intraoperative variables, such as total operative time (148.56 minute vs. 114.28 minute, p-value=0.001) and intraoperative blood loss (68.4 mL vs. 59.2 mL, p-value=0.001) were significantly lesser and favored robot-assisted pyeloplasty over conventional laparoscopic pyeloplasty.Conclusion:In favor of robot-assisted pyeloplasty, both statistically and clinically intraoperative time was lesser, but intraoperative blood loss was lesser only statically and not clinically.
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spelling doaj.art-610745fc52954ce59854c756f4f311a52023-02-15T16:18:45ZengGalenos YayineviJournal of Urological Surgery2148-95802022-03-0191202410.4274/jus.galenos.2021.2021.002413049054Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction ObstructionAditya Abhishek Jha0Arjun Singh Sandhu1Sharat Chandra Dash2Raghav Talwar3Madhu Govindaiah4Gagandeep Singh5Anoop Handa6Nimit Solanki7 Department of Urology, Military Hospital, Secunderabad, Telangana, India Department of Urology, Base Hospital Delhi Cantt, New Delhi, India Department of Urology, Army Hospital Research and Referral, New Delhi, India Department of Urology, Command Hospital Air Force, Bengaluru, Karnataka, India Department of Urology, Command Hospital Air Force, Bengaluru, Karnataka, India Department of Urology, Command Hospital, Udhampur, Jammu and Kashmir, India Department of Urology, Army Hospital Research and Referral, New Delhi, India Department of Urology, Base Hospital Delhi Cantt, New Delhi, India Objective:A surge in the easy availability of robotic platforms has resulted in numerous surgical procedures, which were previously done using an open or conventional laparoscopic approach, are now being done using robots worldwide. A prospective randomized study was conducted to compare surgical and functional outcomes of conventional laparoscopic pyeloplasty with robotic-assisted pyeloplasty.Materials and Methods:Patients who require pyeloplasty who presented to our institute between June 2015 and March 2018 were randomized into a robot-assisted or conventional laparoscopic pyeloplasty group. Common steps included a lateral trans-peritoneal approach, intraoperative antegrade double-J stent placement, stent removal at 4 weeks postoperative, and Diethylene Triamine Penta Acetate renogram at 4 weeks post stent removal. Records of intraoperative and postoperative variables were maintained for all patients. The comparison of continuous numerical data was done using the Independent t-test and categorical non-numerical data using the chi-square (χ2) test. P-values of <0.05 were considered significant.Results:This study includes 58 patients who were randomized into two groups with 29 patients each. No significant difference was noted for postoperative variables, such as the visual analog score for pain, drain placement duration, hospitalization duration, and time to return to daily activity. Intraoperative variables, such as total operative time (148.56 minute vs. 114.28 minute, p-value=0.001) and intraoperative blood loss (68.4 mL vs. 59.2 mL, p-value=0.001) were significantly lesser and favored robot-assisted pyeloplasty over conventional laparoscopic pyeloplasty.Conclusion:In favor of robot-assisted pyeloplasty, both statistically and clinically intraoperative time was lesser, but intraoperative blood loss was lesser only statically and not clinically. http://jurolsurgery.org/archives/archive-detail/article-preview/comparison-of-surgical-and-functional-outcome-of-l/51023 laparascopic pyeloplastyrobotic pyeloplastycongenital ureteropelvic junction obstruction
spellingShingle Aditya Abhishek Jha
Arjun Singh Sandhu
Sharat Chandra Dash
Raghav Talwar
Madhu Govindaiah
Gagandeep Singh
Anoop Handa
Nimit Solanki
Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction
Journal of Urological Surgery
laparascopic pyeloplasty
robotic pyeloplasty
congenital ureteropelvic junction obstruction
title Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction
title_full Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction
title_fullStr Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction
title_full_unstemmed Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction
title_short Comparison of Surgical and Functional Outcome of Laparoscopic Pyeloplasty and Robot-assisted Pyeloplasty for Congenital Uretero Pelvic Junction Obstruction
title_sort comparison of surgical and functional outcome of laparoscopic pyeloplasty and robot assisted pyeloplasty for congenital uretero pelvic junction obstruction
topic laparascopic pyeloplasty
robotic pyeloplasty
congenital ureteropelvic junction obstruction
url http://jurolsurgery.org/archives/archive-detail/article-preview/comparison-of-surgical-and-functional-outcome-of-l/51023
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