The Brigham and Women’s Hospital (BWH) Center for Robotic Surgery is a leader in using state-of-the-art robotics to improve urologic surgery outcomes. This advanced technology’s potential to expand the scope of minimally invasive (laparoscopic) surgery and shorten patient recovery time, combined with the unparalleled experience of our urologic oncology surgical staff, is motivating more and more of our patients to consider robotic pyeloplasty.

What is a pyeloplasty?

Pyeloplasty is the surgical reconstruction or revision of the renal ureteropelvic junction (UPJ) - located between the kidney and the ureter. This is done to eliminate a blockage at the ureteropelvic junction, thereby enabling urine to drain freely from the kidney to the bladder.

What is a robotic pyeloplasty?

Robotic pyeloplasty surgery uses a combination of high-definition 3D magnification, robotic technology and miniature instruments to enhance a urologic surgeon’s skills when correcting a blockage in the renal pelvis.

Jim C. Hu, MD, MPH, Director of Minimally Invasive Urologic Oncology at BWH, uses the FDA-approved da Vinci® Surgical System to perform robotic pyeloplasties. The system consists of a surgeon’s console, equipped with a control panel and a hi-definition monitor, and a patient side-cart, outfitted with slender robotic arms and attended by another surgeon and a nurse.

Open pyeloplasty requires one large incision and retraction to accommodate human hands, but only tiny incisions in the abdomen (see image below) are required for the slender robotic arms and tiny surgical tools used in a robot-assisted pyeloplasty. There are four available arms – one equipped with a high definition 3-D magnification camera, two that act as the surgeon’s arms and a fourth arm that is used for holding back tissue. The camera gives the surgeon enhanced detail, true depth of field and a panoramic view, and the robotic hands’ broad range of movement enables greater dexterity and precision – critical for sewing the urinary system back together. The surgeon remotely guides the robotic arms while seated at the console, located a short distance away from the patient.

You can see how smoothly and accurately the surgeon’s movements are replicated by the robotic arms by watching the da Vinci Technology Overview video. Visit the robotic surgery home page for more details on robotic surgery at Brigham and Women’s Hospital and a photo of the system.

What are the benefits of a robotic pyeloplasty?

Robotic surgery’s miniaturization, increased range of motion, enhanced vision and mechanical precision offer significant benefits for pyeloplasty patients, including:

• Less blood loss
• Less post-surgical pain/less medication
• Quicker recovery and return to normal activities
• Less scarring
  

The tiny incisions required for robotic surgery lead to less blood loss, less scarring, a quicker recovery and a shorter hospital stay.

Who performs robot-assisted pyeloplasties at BWH?

Jim C. Hu, MD, MPH was fellowship trained exclusively in robotic surgery. He subsequently launched the robotic urology program at BWH in September of 2005 and now teaches robotic surgery to surgeons worldwide.

In addition to pyeloplasty, Dr. Hu uses the da Vinci to perform prostatectomy, cystectomy (bladder cancer removal), and radical and partial nephrectomy (kidney cancer removal).

How can I learn more about robotic pyeloplasty?

If you would like to schedule a consultation with Dr. Hu, please call the Patient Referral Service - staffed 8am - 5:30pm, Monday through Friday - at 1-800-BWH-9999, or fill out an online request form..