Da Vinci robotic assisted pyeloplasty versus laparoscopic pyeloplasty in newborns under 3 months

Ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis in children. We aimed to investigate the efficacy of robotic-assisted laparoscopic pyeloplasty (RALP) in newborns with UPJO compared to laparoscopic pyeloplasty (LP). We conducted a retrospective study of newborns aged ≤ 3 months who underwent RALP or LP from May 2018 to December 2023. Only primary pyeloplasty cases were included. Seventy-seven newborns (RALP = 46; LP = 31) were enrolled and no significant difference in the newborns' demographics and pre-operative parameters was found. The mean operation time (OT) was 161.30 ± 29.07 min (RALP) and 200.60 ± 26.66 min (LP) (P < 0.0001), and the mean hospitalization stay was 7.80 ± 1.13 days (RALP) and 9.32 ± 1.19 days (LP) (P < 0.0001). RALP was associated with a higher hospitalization cost than LP (73449 ± 8513 yuan vs. 40152 ± 7555 yuan; P < 0.0001). The effectiveness and safety of RALP for treating UPJO in newborns is comparable to that of LP. In addition, RALP might have advantages over LP with its faster recovery and less trauma.