机器人辅助腹腔镜肾盂成形术

目的探讨机器人辅助腹腔镜肾盂成形术治疗肾盂输尿管连接部(UPJ)狭窄所致肾积水的临床疗效。方法采用经腹腔途径施行机器人辅助腹腔镜肾盂成形术治疗UPJ狭窄25例，男18例，女7例。B超提示重度肾积水10例、中度10例、轻度5例。IVU均显影。结果25例手术均获成功。手术时间60—200min，平均90min；出血量40-80ml；术后住院时间6—9d，平均7d。术后随访3-32个月，25例腰痛症状均消失，逆行肾盂造影(RP)示UPJ吻合口无狭窄；肾积水减轻，10例重度肾积水者中8例转为中度、2例转为轻度，10例中度积水者中3例转为轻度、7例积水消失，5例轻度肾积水者积水消失。IVU、CT尿路造影(CTU)显影良好者18例，显影改善者7例。结论机器人辅助腹腔镜肾盂成形术治疗UPJ狭窄所致肾积水使手术效率提高，操作更加精确，疗效满意。

Robot-assisted transperitoneal laparoscopic pyeloplasty

ObjectiveTo describe the new technique of robot-assisted transperitoneal laparoscopic pyeloplasty for ureteropelvic junction (UPJ) stricture and to evaluate its clinical efficacy.MethodsOf the 25 cases (18 men and 7 women) of UPJ stricture who underwent robot-assisted transperitoneal laparoscopic pyeloplasty,10 cases had severe hydronephrosis;10,intermediate;and 5 mild by B-ultrasound examination.Using intravenous urography (IVU) or CT urography (CTU),18 cases had good image;while 7 had poor imageResultsThe operation was successful in all the 25 cases with the operative time being 60-200 min(mean,90 min) and blood loss,40-80 ml.The mean hospital stay was 7 d (range,6-9 d).Follow-up of 3-32 months showed that lumbago disappeared in 25 cases and there was no stricture at UPJ by retrograde pyelography(RP).Hydronephrosis was remitted (among 10 cases with severe hydronephrosis, hydrops remitted from severe to intermediate in 8 and to mild in 2;among 10 cases with intermediate hydronephrosis, hydrops remitted from intermediate to mild in 3 and 7 had resolution;5 cases with mild hydronephrosis had resolution).IVU and CTU showed good image in 18 cases and improved image in 7.Conclusions Robot-assisted transperitoneal laparoscopic pyeloplasty is a more effective, more precise and minimally invasive surgical management for UPJ stricture.