Robotic renal pelvis plastic repair

Robotic surgery is a minimally invasive surgery that uses tiny surgical tools guided by an advanced robot. It is a highly advanced technology that allows surgeons to perform surgeries with extreme precision.

Due to its numerous benefits for both the patient and the surgeon, robotic surgery becomes a viable option for a wide range of surgical procedures. Prostate cancer (prostatectomy), kidney cancer (nephrectomy), bladder cancer (cystectomy), ureteral re-implantation, and renal pelvic plastic surgery (pyeloplasty) are all performed with robots.

Renal pelvic plastic surgery:
It is the reconstructive or plastic surgery of one or both ureters to remove a narrowing or obstruction. Surgery for ureteral reconstruction is required when scar tissue develops in the ureter as a result of an injury, surgery, or disease such as endometriosis or cancer. The narrowing occurs due to the presence of this scar tissue in the ureter. As a result, urine does not flow down the ureter and instead accumulates in the kidney, causing pain and potentially leading to urinary tract infection and nephritis.

Application of the surgical robot in renal pelvic plastic surgery:
Robotic surgery is performed by tiny surgical instruments on the robot's arms and controlling them remotely via a control panel. The robot mimics the surgeon's movements without the vibration associated with human hands. Moreover, the ability to move surgical instruments up to 360 degrees is impossible in human hands.

The surgical robot allows a 3D view of the internal body parts, which permits depth understanding. Also, it can magnify the image on the screen. Therefore, the surgical robot is an advanced system designed to expand the capabilities of the surgeon, and it offers the latest in minimally invasive methods of surgical robotic ureteroplasty. Other advantages of this surgical treatment include:
- Minimum scarring.
- Least post surgical pain.
- Minimal risk of infection and other side effects.
- Less hospitalization time.

The surgical robot does not perform the surgery, but Prof. Mahmoud AbdelHakim, Professor of Urology, Cairo University, uses robotic technology. Robotic surgery allows access to narrow body areas and prevents natural manual vibration, allowing precise surgery by permitting a 3D visual field.

Steps of renal pelvic plastic surgery:
The surgery is usually done under general anesthesia. The surgery involves making several small incisions in the abdomen. Through these small incisions, the surgical robotic arms pass, which transfer images from the inside of the abdomen to the video screen, and carry the surgical tools needed for surgery. 
Prof. Mahmoud AbdElHakim, Professor of Urology, Cairo University, cuts the narrow part of the ureter with a surgical robot. If a large part is removed, the surgeon repairs the ureter with other tissues taken from another part of the body, such as the bladder, and then sutures by several sutures that decompose over time.
Long, flexible tubes called stents are placed in the ureter and extend from the kidney to the bladder. They are kept in place for 4 to 6 weeks after surgery to help keep the ureter open during treatment.
After surgery, those minor incisions are closed. One or more tubes may be placed near one of the incisions to drain fluid that can build up after surgery.

The recovery period after robotic renal pelvic plastic surgery: 
One of the main advantages of robotic surgery versus traditional surgery is the quick recovery. In many cases, the patient can leave the hospital on the same day of the surgery. In other cases, the patient may remain in the hospital for about 24 hours. Other than painkillers prescribed by Prof. Mahmoud AbdElHakim, there is no special care after surgery.