Comparative analysis of robotic-assisted and conventional laparoscopic ureterolithotomy: A single-center retrospective study

Abstract Background: Robotic-assisted laparoscopic ureterolithotomy (LU) (RALU) has been proposed as an alternative to conventional LU for managing complex ureteral stones. However, direct comparative evidence on clinical outcomes remains limited. Objectives: This study aimed to directly compare perioperative outcomes and complication profiles between RALU and LU in a single-center cohort. Methods: We conducted a retrospective cohort study of 45 patients undergoing ureterolithotomy at a single institution from January 2016 to December 2023. Of these, 27 and 18 patients received RALU and LU, respectively. Patient demographics, stone characteristics, operative parameters, and postoperative outcomes were analyzed. Complications were classified using the Clavien–Dindo Grading System. Results: Both groups had comparable operative times (RALU, 146.7 ± 43.3 min vs. LU, 141.7 ± 60.2 min) and blood loss (24.1 ± 26.8 vs. 24.2 ± 50.0 mL). The RALU group had a shorter mean stenting duration (31.3 ± 11.5 vs. 88.9 ± 216.0 days); however, was not statistically significant. No moderate complications (Clavien grade ≥A2) developed in the RALU group, whereas 11.1% of the patients who received LU experienced such events, including fever and ureteral stricture. Both groups experienced similar rates of abdominal fullness ( n = 3). No patients required blood transfusions. Conclusion: RALU provides a comparable operative profile to LU but offers distinct advantages in terms of reduced stenting duration and lower complication rates. These findings support the clinical feasibility and potential safety benefits of robotic assistance in ureterolithotomy, particularly in settings with available resources and technical expertise.