{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:44:22Z","timestamp":1767339862683,"version":"build-2065373602"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,14]],"date-time":"2020-11-14T00:00:00Z","timestamp":1605312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Ureterocalycostomy is a necessary option for renal salvage in cases where conventional reconstructions have failed or as a primary option in anatomic situations such as intrarenal pelvis, malrotated, or horseshoe kidney. The primary principle of this procedure is to allow for dependent drainage. Ureterocalycostomy is often difficult due to extensive scar tissue and may be complicated by bleeding in the setting of a normal functioning lower pole cortex, compared to thin renal cortex and poor renal function as seen in end\u2010spectrum of the obstruction. Identification of a dependent calyx and hemostasis can be difficult when there is a normal cortical thickness. Though the vascular control of hilum is an option, we suggest some simple tips to avoid this step and optimize surgical results. We present our experience and salient technical tips with pediatric robotic\u2010assisted laparoscopic ureterocalycostomy and provide a step\u2010by\u2010step video.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four patients underwent robotic\u2010assisted laparoscopic ureterocalycostomy between the years 2012 and 2016 by a single surgeon. Perioperative outcomes measured included operative time, hospital stay, pain relief, degree of hydronephrosis on postoperative ultrasound at 3\u00a0months, and renal scintigraphy as needed. We describe the operative procedure and provide tips on identifying a dependent lower pole calyx with flexible nephroscopy and needle puncture, the use of harmonic scalpel for incision of the lower pole cortex, and anastomosis by pre\u2010placement of interrupted sutures as the urothelium of the renal calyces is thin and friable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients ranged in age between 11\u00a0months and 14\u00a0years old. Three of four patients had one prior pyeloplasty, and one patient had two prior pyeloplasties. Mean operative time (incision to closure) was 208\u00a0minutes. No Clavien\u2010Dindo 30\u2010day complications were encountered and no patients required blood transfusion. Anatomic success was reported in all patients with a mean follow\u2010up of 4.46\u00a0years; however, one patient ultimately required nephrectomy despite patent anastomosis, which would not drain due to a capacious pelvis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Robotic\u2010assisted laparoscopic ureterocalycostomy is feasible in re\u2010operative cases with extensive scaring and in patients with normal lower pole renal cortex. We offer tips to allow for safe and proficient performance of this procedure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.53","type":"journal-article","created":{"date-parts":[[2020,11,14]],"date-time":"2020-11-14T04:50:49Z","timestamp":1605329449000},"page":"53-57","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pediatric robotic\u2010assisted laparoscopic ureterocalycostomy: Salient tips and technical modifications for optimal repair"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8394-7491","authenticated-orcid":false,"given":"B. 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S.","family":"Gundeti","sequence":"additional","affiliation":[{"name":"Pediatric Urology Section of Urology Department of Surgery Comer Children\u2019s Hospital Pritzker School of Medicine The University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.06.079"},{"issue":"3","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1097\/01.ju.0000114233.66534.b0","article-title":"Laparoscopic ureterocalicostomy: initial experience","volume":"171","author":"Gill IS","year":"2004","journal-title":"J Urol"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-013-0591-z"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aju.2016.01.001"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/cren.2018.0082"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.08.052"},{"issue":"5","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.juro.2018.10.021","article-title":"Robot\u2010assisted laparoscopic reoperative repair for failed pyeloplasty in children: an updated series","volume":"201","author":"Jacobson DL","year":"2019","journal-title":"J Urol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2011.01.044"},{"issue":"1","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jpurol.2009.02.102","article-title":"Role of ureterocalicostomy in children: a follow up study","volume":"5","author":"Radford A","year":"2009","journal-title":"J Ped Urol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1990.tb14748.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)39058-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-7796.216312"},{"issue":"5","key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jpurol.2019.05.032","article-title":"Pyeloplasty vs nephrectomy for ureteropelvic junction obstruction in poorly functioning kidneys (differential renal function <20%): a multicentric study","volume":"15","author":"Gnech M","year":"2019","journal-title":"J Pediatr Urol"},{"issue":"20","key":"e_1_2_7_15_1","first-page":"30850","article-title":"Multi\u2010institutional experience comparing outcomes of adult patients undergoing secondary versus primary robotic pyeloplasty","volume":"4295","author":"Lee M","year":"2020","journal-title":"Urology"}],"container-title":["BJUI Compass"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bco2.53","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bco2.53","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bco2.53","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T20:07:58Z","timestamp":1759954078000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1002\/bco2.53"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,14]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/bco2.53"],"URL":"https:\/\/doi.org\/10.1002\/bco2.53","archive":["Portico"],"relation":{},"ISSN":["2688-4526","2688-4526"],"issn-type":[{"type":"print","value":"2688-4526"},{"type":"electronic","value":"2688-4526"}],"subject":[],"published":{"date-parts":[[2020,11,14]]},"assertion":[{"value":"2020-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}