Advances in robot-assisted upper urinary tract reconstruction: Surgical techniques, emerging technologies, and complex clinical scenarios

The aim is to provide a comprehensive review of recent advances in robot-assisted upper urinary tract (UUT) reconstruction, including surgical techniques, emerging technologies, and management strategies for complex clinical scenarios. This narrative review summarizes published evidence from randomized controlled trials, meta-analyses, cohort studies, case series, and significant case reports on robot-assisted UUT reconstruction. Key topics include the technical details and outcomes of various robotic procedures, integration of new imaging and navigation technologies, and application of robotic surgery in anomalous anatomy, redo surgeries, and posttransplant or ureteroenteric stricture cases. Robot-assisted UUT reconstruction offers significant advantages over traditional approaches, including reduced intraoperative blood loss, shorter postoperative recovery time, and improved precision, particularly in complex and anatomically challenging cases. The adoption of advanced technologies, such as three-dimensional image reconstruction, indocyanine green fluorescence imaging, and single-port robotic platforms, has further enhanced surgical planning, intraoperative navigation, and overall safety. However, the current evidence is primarily based on retrospective single-center studies, with limited large-scale or long-term data. Outcome definitions and success criteria remain heterogeneous, limiting direct comparisons and standardized recommendations. Robot-assisted UUT reconstruction is becoming a standard option, strengthened by advanced imaging and single-port platforms. To consolidate its role, multicenter prospective studies with standardized outcomes and long-term follow-up are needed to refine the indications and ensure responsible adoption.