Objective: To report a comparison of two techniques of robotically assisted laparoscopic dismembered pyeloplasty (RALDP), and their associated outcomes, for treating pelvi-ureteric junction obstruction (PUJO), evaluating the potential differences in the initial 50 cases of two centres in North America and Europe.
Patients and methods: Between November 2001 and August 2005, 100 patients had transperitoneal RALDP for PUJO in one centre in the USA (group 1) and one in France (group 2). Group 1 consisted of 50 patients (30 males and 20 females, mean age 31 years, range 16-62) and group 2 of 50 patients (17 males and 32 females, one bilateral PUJO; mean age 39 years, range 17-81). The right side was affected in 30 (60%) patients in group 1 and 32 (64%) in group 2. Differences in preoperative evaluation, surgical technique and follow-up were evaluated.
Results: In group 1 all procedures were completed laparoscopically. One conversion was necessary in group 2 due to technical difficulties. The mean operative duration was 122 min (group 1) and 127 min (group 2); the estimated blood loss was negligible (<100 mL) in both groups. Surgical findings included 15 patients with crossing vessels in group 1 and 28 in group 2. There were no peri-operative complications in either group. The mean hospital stay was 1.1 days in group 1 and 5.8 days in group 2, reflecting differences in practice patterns. All patients were asymptomatic at stent removal and in subsequent clinical evaluations in both groups.
Conclusion: The combination of results form both series provide information suggesting that the robotically assisted approach is a viable treatment option. The results reflect some differences in techniques, follow-up and practice patterns, but the outcomes were equally effective on both continents. Further follow-up will allow us to determine the long-term efficacy.