Robotic Pyeloplasty

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Brigham and Women’s Hospital (BWH) 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 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.

Open pyeloplasty typically requires a large abdominal incision and retraction to accommodate human hands, but only small incisions (see image below) are required for the robotic arms and 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.

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

Who performs robot-assisted pyeloplasties at BWH?

Adam S. Kibel, MD, and Steven Lee Chang, MD, MS, represent the robotic urology program at BWH, one of the largest robotic surgery practices in New England. Dr. Kibel, Chief of Urology, has specialized in minimally invasive surgery for urologic cancer for over 15 years. He is one of the most experienced robotic surgeons in New England and one of the most respected cancer surgeons in the country. He has lectured and published widely on the techniques and outcomes of robotic-assisted prostatectomy, partial nephrectomy, and cystectomy.

Dr. Chang completed a fellowship in urologic oncology at Stanford University Medical Center, with an emphasis on minimally invasive surgery. As a result, Dr. Chang employs robotic surgery for nearly all his patients with cancer of the kidney, prostate, or bladder. Dr. Chang frequently lectures on robotic urologic surgery and actively conducts research focused on optimizing robotic techniques and outcomes.

How can I learn more about robotic pyeloplasty?

If you would like to schedule a consultation with our surgeons, please call the Patient Referral Service - staffed 8am - 5:30pm, Monday through Friday - at 1-800-294-9999, or fill out an online request form.

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