Robotic Pyeloplasty
Robotic pyeloplasty is the gold-standard surgical treatment for ureteropelvic junction (UPJ) obstruction—a condition where the connection between the kidney and ureter becomes blocked, preventing normal urine drainage. This obstruction can cause pain, recurrent infections, kidney stones, and progressive kidney damage if left untreated. Dr Brendan Dias performs robotic pyeloplasty using the da Vinci surgical system, which provides enhanced visualisation, precision instrument control, and the ability to perform delicate reconstructive suturing through small keyhole incisions. The procedure removes the blocked segment and creates a new, wide connection between the kidney and ureter. The robotic approach offers significant advantages over traditional open surgery, including faster recovery, less pain, shorter hospital stays, and excellent long-term success rates of 95-98%.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (Urology), DrNB (Urology), FRCS (Urol), FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- 95-98% long-term success rate for relieving obstruction
- Minimally invasive with 4-5 small keyhole incisions
- Significantly reduced postoperative pain compared to open surgery
- Hospital stay of just 1-2 nights in most cases
- Return to normal activities within 2-3 weeks
- Excellent cosmetic outcome with minimal scarring
- Enhanced precision for complex reconstructive suturing
- Suitable for revision surgery after failed previous repair
The Procedure
Robotic pyeloplasty is performed under general anaesthesia. The patient is positioned on their side, and 4-5 small ports (8-12mm) are placed for the robotic camera and instruments. The surgeon works from a console with 3D high-definition visualisation and wristed instruments that provide 7 degrees of freedom—greater than the human hand. The kidney and blocked ureteropelvic junction are carefully exposed. The narrowed or obstructed segment is excised, and the healthy ureter is spatulated (opened along its length) to create a wider opening. If crossing blood vessels are causing compression, they are repositioned. A watertight anastomosis (connection) is created between the renal pelvis and ureter using fine absorbable sutures. A temporary internal stent is placed to protect the repair. The operation typically takes 2-3 hours. The stent remains in place for 4-6 weeks and is removed in a brief clinic procedure.
Who Is a Candidate?
Robotic pyeloplasty is suitable for patients with confirmed ureteropelvic junction obstruction causing symptoms (pain, infections) or kidney damage, those with congenital or acquired UPJ obstruction requiring surgical correction, patients seeking minimally invasive treatment with faster recovery than open surgery, candidates with failed previous endoscopic treatment (endopyelotomy), those requiring revision surgery after previous failed pyeloplasty, patients with crossing vessels causing secondary UPJ obstruction, and those with good overall health to tolerate general anaesthesia.
Recovery
Most patients are mobilised on the day of surgery and discharged home after 1-2 nights in hospital. The urinary catheter is typically removed the morning after surgery before discharge. Light activities including walking are encouraged from day one; driving can resume after 1-2 weeks. The internal stent may cause some urinary frequency, urgency, or mild flank discomfort—this is normal. Return to work typically occurs within 2-3 weeks for desk jobs; physical work requires 4-6 weeks. The stent is removed at 4-6 weeks via a brief cystoscopy (takes 2-3 minutes). Follow-up imaging (usually a MAG3 renogram) is performed at 3 months to confirm successful repair.
Risks & Considerations
As with any surgical procedure, robotic pyeloplasty carries some risks including bleeding requiring transfusion (rare, <1%), infection or urine leak at the repair site, stent-related symptoms (frequency, discomfort) which are temporary, stricture or recurrence of obstruction (2-5%), injury to surrounding structures, conversion to open surgery if needed (rare), and blood clots in legs (DVT) or lungs (PE).