Robotic-assisted pyeloplasty is a minimally invasive procedure used to correct a blockage where the kidney connects to the ureter—known as a pelvic-ureteric junction (PUJ) obstruction. This condition can prevent urine from draining properly, leading to symptoms such as pain, infection, and potential kidney damage.

Using the da Vinci Surgical System, a robotic-assisted platform, the surgeon is able to perform this delicate reconstructive procedure with enhanced precision and minimal disruption to surrounding tissue.

At Urology SA, Dr Jimmy Lam is highly experienced in robotic urological surgery. His personalised approach ensures each patient receives expert care tailored to their specific condition.

Who is suitable for robotic-assisted pyeloplasty?

Robotic pyeloplasty is the gold-standard treatment for patients with PUJ obstruction—a narrowing at the junction where the kidney (renal pelvis) drains into the ureter.

Common symptoms of PUJ obstruction include:

  • Flank or back pain
  • Recurrent urinary tract infections
  • Reduced kidney function
  • Nausea or vomiting (especially after fluid intake)

This procedure is suitable for both adults and selected paediatric patients, and is particularly recommended when a minimally invasive approach is desired for quicker recovery.

Advantages of robotic-assisted pyeloplasty

Compared to traditional open or even standard laparoscopic pyeloplasty, the robotic-assisted approach offers significant advantages for both patients and surgeons.

For the patient:

  • Smaller incisions and less scarring
  • Reduced blood loss
  • Less postoperative pain
  • Shorter hospital stay
  • Quicker return to normal activities
  • Lower risk of complications

For the surgeon:

  • High-definition, magnified 3D vision inside the body
  • Fine, articulated robotic instruments allowing exceptional precision and range of motion

How the procedure is performed

The procedure takes place under general anaesthetic and typically lasts a few hours.

Steps include:

  1. 3–5 small incisions are made in the abdomen to insert the robotic instruments and camera.
  2. The surgeon uses robotic controls to remove the narrowed segment of the ureter.
  3. The healthy ureter is carefully reconnected to the renal pelvis using fine sutures.
  4. A temporary internal stent is placed in the ureter to support healing. This is removed after approximately 6 weeks via a simple flexible cystoscopy (a quick, no-cut procedure under light sedation).

What to expect after surgery

  • Most patients stay in hospital for 1–2 nights.
  • A urinary catheter is usually left in place for 24 hours.
  • A small surgical drain may be placed near the kidney to remove excess fluid and is removed within a day or two.
  • Walking is encouraged early to reduce the risk of pneumonia or blood clots.
  • Most light activities can resume within a few days.
  • Strenuous activities and heavy lifting should be avoided for 4–6 weeks.
  • Your stent will be removed in a day procedure approximately 6 weeks after surgery.

If you have any concerns following discharge or before your follow-up appointment, our team is available to support your recovery and address any questions.