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Kidney Blockage Surgery

Procedure overview

Pyeloplasty is a type of surgery that is done to repair the ureter – a tube that attaches the kidney to the bladder. This inpatient procedure, performed by a general surgeon or urologist, and is used to correct a ureteropelvic junction (UPJ) obstruction.[1] Ureteropelvic junction (UPJ) obstruction is a blockage in the renal pelvis of the kidney. The renal pelvis is located at the upper end of each ureter (tube that drains urine from the kidneys to the bladder). The renal pelvis, which is shaped like a funnel, collects urine.  In UPJ obstruction, the flow of urine is slowed or stopped completely. This raises the risk of kidney damage. In most cases of UPJ obstruction, only one of the kidneys is affected.[2] Open pyeloplasty typically requires a large abdominal incision and retraction to accommodate human hands, but only small incisions are required for the robotic arms and surgical tools used in a robot-assisted pyeloplasty.[3]  During robotic pyeloplasty the UPJ is removed, and the ureter is reattached to the renal pelvis with a wider opening. The goal of the surgery is to allow urine to drain freely, eliminate symptoms and reduce the chances of infection.[4]
Figure 1. Open vs Laparoscopic vs Robotic, Port Placement for Pyeloplasty Surgery

Learn more about what robotic assisted surgery is and how surgeons use the technology here.

Articles

Ureteral Obstruction – Salimas story
Humber River Hospital Foundation, March 2021

Hospital surgeons go where no surgeon has gone before

St Michaels Hospital, March 2008

Potential Benefits​

Studies on Robot assisted pyeloplasty have reported the following results:
  • Potential benefits compared to open surgery for pediatric patients:
    • Shorter length of stay [5,6]
    • Less need for narcotic pain medicine [5,6]
    • Minimal Scarring
  • Potential benefits compared to traditional laparoscopy for pediatric and adult patients:
    • Shorter length of stay [6,7,8]

Additional Patient Resources

Visit the the Canadian Urology Association for more informational about the disease, diagnosis, treatment options and support available.

Educational Videos

 

Dr. Marshall Wingo of Roper St. Francis (US) describes how surgeons can use robotic-assisted surgery to help correct kidney blockages. [US Content]

Risks & Considerations

Not everyone is a candidate for robotic assisted procedures, and other treatment options may be available and appropriate. Only a doctor can determine whether robotic assisted surgery is appropriate for a patient’s situation. Surgery of any form contains risks and it is important to discuss risks with your provider. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision. 

Patients have also developed support areas where they are able to speak with each other about the surgery, their experiences, and any issues that they have faced during their treatment. To learn more check out the additional resources above or visit the community section of this website. 

[1] Cleveland Clinic: Https://my.clevelandclinic.org/health/treatments/16545-pyeloplasty

[2] Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/16596-ureteropelvic-junction-obstruction

[3]  https://www.brighamandwomens.org/surgery/urology/robotic-surgery-procedures/robotic-pyeloplasty

[4] https://www.urologyhealth.org/urology-a-z/u/ureteropelvic-junction-(upj)-obstruction#:~:text=Open%20Surgery,and%20the%20risk%20of%20infection.

[5] D. Bansal, et al. Infant robotic pyeloplasty: Comparison with an open cohort. Journal of Pediatric Urology (2014) 10, 380e385.
[6] Cundy T, et al. Meta-analysis of robotic-assisted vs conventional laparoscopic and open pyeloplasty in children. BJU International, 2014; doi:10.1111/bju.12683
[7] Hemal AK, et al. Laparoscopic pyeloplasty versus robotic pyeloplasty ureteropelvic junction obstruction: a series of 60 cases performed by a single surgeon. www.ncbi.nlm.nih.gov/pubmed/20156381\o The Canadian journal of Urology. Can J Urol. 2010 Feb;17(1):5012-6.
[8] Wang F, et al. Robot-assisted versus laparoscopic pyeloplasty for patients withureteropelvic junction obstruction: An updated systematic review and metaanalysis. Scandinavian Journal of Urology, doi:10.3109/21681805.2013.780184.