26 June, 2025 by Admin

Robotic Pyeloplasty in Children – Precision Kidney Surgery at BLK- Max,  Max Hospital, Dwarka and Max hospital Gurugram, Delhi

Max Super Speciality Hospital, Delhi is proud to offer one of the most advanced solutions for children with ureteropelvic junction (UPJ) obstruction—robotic-assisted laparoscopic pyeloplasty. This is a minimally invasive surgical procedure that uses the precision of robotic technology to correct a blockage between the kidney and the ureter (urine drainage tube), ensuring normal urine flow and protecting kidney function.

What Is UPJ Obstruction and Why Does It Matter?

The ureteropelvic junction (UPJ) is where the kidney connects to the ureter. In some children, this junction is narrowed or blocked (either from birth or due to crossing blood vessels), causing urine to back up into the kidney. This results in:

• Hydronephrosis (kidney swelling)
• Recurrent urinary tract infections
• Pain in the side or abdomen
• Poor kidney function over time

If untreated, this can lead to permanent kidney damage.

How Is Robotic Pyeloplasty Performed?

Pre-operative Planning

Before surgery, your child undergoes:

• Ultrasound
• Renal scan (DTPA or MAG3) to check how well each kidney is working
• Blood and urine tests

Anesthesia and Positioning

• The surgery is done under general anesthesia by pediatric-trained anesthesiologists.
• Your child is carefully positioned on their side, and the abdomen is cleaned and draped under sterile conditions.

Step-by-Step Surgical Procedure

Port Placement (Access Points for Surgery)

Three to four tiny incisions (5–8 mm each) are made on your child’s abdomen.

These are called ports—they allow entry of the robotic arms and camera into the abdominal cavity.

• One port holds a 3D high-definition camera.
• Two or three other ports are used for robotic surgical instruments.

These incisions are extremely small and placed strategically to ensure minimal visible scarring later.

Robotic Dissection of the Blocked Junction

• The surgeon, seated at a robotic console, uses master controls to guide the robot’s arms with great precision.
• The obstructed segment of the ureteropelvic junction is identified and carefully separated from surrounding tissues using fine robotic tools.
• Any crossing blood vessels (which sometimes cause the obstruction) are preserved or gently moved aside.

Excision and Anastomosis (Stitching the Kidney and Ureter)

• The narrowed portion of the ureter is removed.
• The healthy end of the ureter is then reconnected to the renal pelvis (the funnel-shaped part of the kidney) using very fine sutures under high magnification.
• This process is called anastomosis.

These stitches are extremely delicate and precise—robotic assistance makes this possible even in very small children.

Placement of a DJ (Double J) Stent

• A soft plastic tube called a DJ stent is placed inside the ureter during surgery.
• This stent acts like a scaffold, allowing urine to flow freely and ensuring the newly joined area heals properly.
• The DJ stent remains in place for 4–6 weeks and is removed later through a short day-care procedure using a thin scope passed via the urinary passage (no cuts are needed for stent removal).

Closure and Recovery

• The robotic instruments are withdrawn.
• The small port sites are closed with absorbable stitches, and covered with small dressings.
• No external stitches need to be removed later.

Why Robotic Pyeloplasty at Max Hospital?

• Minimally Invasive: Very small cuts mean less pain, less blood loss, and quicker recovery.
• High Precision: The robotic system enables millimeter-level accuracy, especially important in small children.
• Better Outcomes: Studies show robotic pyeloplasty has equal or better success than open surgery, with faster healing and excellent cosmetic results.
• Short Hospital Stay: Most children are discharged within 2–3 days.
• Expert Team: Our team includes fellowship-trained pediatric robotic surgeons, supported by child-specific anesthesia and recovery protocols.

What to Expect After Surgery

• Mild pain, usually managed with oral medications
• Oral feeds start the same day or next day
• Child can walk within a day
• Full recovery in 5–7 days
• DJ stent is removed **after 4–6 weeks

Category : Robotic Surgery