Ces Urol 2026, 30(1):24-29 | DOI: 10.48095/cccu2026007

Robot-assisted Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction in children

Zuzana Študentová, Vladimír Študent jr., Jan Šarapatka, Oldřich Šmakal

Urologická klinika LF UP a FN Olomouc

Major statement: Robot-assisted pyeloplasty in children, except for very young children, where the use of robotics is limited by instrument size and anesthesia duration, is becoming the preferred surgical modality and the new standard of treatment for ureteropelvic junction obstruction.

Summary: Objective: The aim of this study was to evaluate perioperative and functional outcomes of pediatric patients who underwent robot-assisted Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction using a robotic surgical system.

Patients and Methods: Pediatric patients aged ≤ 18 years who underwent robot-assisted laparoscopic pyeloplasty (RALP) between March 2014 and May 2025 were retrospectively identified from our institutional database. Demographic and clinical characteristics, perioperative outcomes, type of renal drainage, pelvic resection, postoperative complications, and functional outcomes were recorded and analyzed.

Results: A total of 42 children were included in the analysis. The median age was 14 (range 5–18) years, and the median body weight was 54 (range 18.5–80) kg. The median operative time was 121 (range 43–207) minutes, and the median console time was 82 (range 34–157) minutes. A double-J stent was placed in 28 patients (64.3%) and removed after a median of 53 (36–630) days. Pyelostomy was used in 14 patients and removed after a median of 10.5 (8–14) days. The median length of hospital stay was 8 (range 5–17) days. At the time of data analysis, the median postoperative follow-up was 21.5 (4–104) months. Complications occurred in 9 patients (21.4%), with major complications (Clavien-Dindo grade ≥ III) observed in 4 patients (9.5%; 2 stent obstructions, 1 stent dislocation, and 1 stent encrustation). No ureteropelvic junction restenosis or deterioration of renal function was observed during follow-up. The overall success rate of RALP was 100%.

Conclusion: These data support RALP as a safe and effective treatment option for ureteropelvic junction obstruction in pediatric patients.

Keywords: pyeloplasty – ureteropelvic junction obstruction – pediatric urology – robot-assisted surgery

Received: February 16, 2026; Revised: March 10, 2026; Accepted: March 11, 2026; Published: March 27, 2026