Risk Factors for Prolonged Robot‐Assisted Laparoscopic Pyeloplasty: A Single‐Center Retrospective Study
Kohei Mori, Izuru Shiba, Yutaka Shiono, Soichiro Shimura, Shuhei Hirano, Masaomi Ikeda, Daisuke Ishii, Masatsugu Iwamura, Kazumasa MatsumotoABSTRACT
Introduction
Robot‐assisted pyeloplasty has become a standard minimally invasive procedure for ureteropelvic junction obstruction; however, factors associated with a prolonged operation remain incompletely understood. In this study, we aimed to identify risk factors for a prolonged operation at a single institution.
Methods
We retrospectively reviewed the data of 100 consecutive patients who underwent robot‐assisted pyeloplasty at our institution between April 2016 and January 2026. Patients were divided into two groups based on the operative time: the prolonged group (≥ 75th percentile) and the non‐prolonged group (< 75th percentile). Clinical and anatomical variables were analyzed, and a multivariable logistic regression model was constructed to identify independent predictors of a prolonged operation.
Results
In the multivariable analysis, high ureteral insertion (odds ratio: 5.6; 95% confidence interval: 1.8–18.3; p = 0.0047), male sex (3.3; 1.2–9.9; p = 0.024), and preoperative ureteral stenting (3.7; 1.32–11.2; p = 0.015) were identified as significant independent predictors of a prolonged operation. Neither postoperative complication rates ( p = 0.33) nor surgical success rates ( p = 0.25) differed between the groups.
Conclusion
High ureteral insertion, male sex, and preoperative ureteral stenting were significant independent predictors of prolonged robot‐assisted pyeloplasty. Nonetheless, these factors were not associated with surgical success or complication rates, confirming the safety and effectiveness of robot‐assisted pyeloplasty even in challenging cases.