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Robotic Surgery - Robotic Surgery for UPJ Repair

About the Kidneys and the UPJ

The kidneys are two large, bean-shaped organs on either side of the spine below the rib cage. Each kidney is attached to the bladder by a long, thin tubular channel called a ureter. Urine is made in the kidney and flows through this channel to the bladder. The kidney and ureter attach at a spot called the ureteropelvic junction (UPJ). Scarring can develop at this junction as a result of urinary stones, surgery, or infections, or it can become obstructed by blood vessel compression, gradual narrowing, or other causes. Many patients are born with a blockage at the UPJ and will need surgery later in life.

When the UPJ becomes obstructed, urine cannot flow freely through the ureter and pressure builds up in the kidney. If a UPJ obstruction is not treated, the affected kidney may be permanently damaged and no longer able to function. Surgeons correct this problem with a procedure called a minimally invasive robotic pyeloplasty. They remove the diseased part of the ureter and sew the two normal ends back together to re-create the tube.

About Robotic Surgery for UPJ Repair

Surgeons at Columbia University Department of Urology at NewYork-Presbyterian Hospital perform minimally invasive robotic pyeloplasty using the da Vinci robotic surgical system. During minimally invasive robotic pyeloplasty the surgeon sits at a console next to the patient and controls four robotic arms. One arm holds a three-dimensional camera and controls its movements, while the other three hold miniaturized surgical tools, which precisely replicate the surgeon's hand and finger movements. The da Vinci robotic surgery system gives the surgeon a highly magnified view of the surgical field, and unsurpassed surgical dexterity and control. Surgeons operate through several tiny holes in the abdomen, and can very precisely cut the obstructed area from the ureter and re-create the channel with healthy tissue.

After surgery patients have minimal pain and are often walking the same day. Most patients are able to go home the day after the procedure.