[Evaluation of the feasibility and safety of a Chinese developed modular surgical robotic system for robot-assisted pyeloplasty].

Abstract

Objective: To evaluate the technical feasibility and perioperative safety of pyeloplasty assisted by the Carina^TM modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction (UPJO).

Methods: From November to December 2024, five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the Carina^TM modular laparoscopic surgical system at Peking University First Hospital. Data on patient demographics, intraoperative parameters (including docking time, console time, and estimated blood loss), perioperative outcomes, follow-up results, and surgeons' subjective evaluations of system performance were prospectively collected. Descriptive statistics were used; continuous variables were presented as median (range), and categorical variables as frequency and percentage.

Results: The cohort included four females and one male. All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery. The median age was 32 years (24-37 years), and the median body mass index was 21.6 kg/m² (15.8-27.3 kg/m²). The median docking time was 8 min (3-12 min), and the median console time was 91 min (71-125 min). Intraoperative blood loss was uniformly 20 mL. The median postoperative drainage duration was 3 d (0-4 d), and the median length of hospital stay was 4 d (4-9 d). No Clavien-Dindo grade Ⅲ or higher complications occurred. All the patients had their double-J stents removed at 2 months postoperatively, and pain in the ipsilateral flank, reported preoperatively by all the five patients, was alleviated. The subjective surgical success rate was 100%. Surgeons reported stable system performance throughout all the procedures, with no instances of mechanical arm interference or visual drift affecting surgical fluency.

Conclusion: Preliminary findings indicate that pyeloplasty using the domestically deve-loped Carina^TM modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.