{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:40:20Z","timestamp":1792813220077,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":295,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Robot\u2010assisted pyeloplasty has become a standard minimally invasive procedure for ureteropelvic junction obstruction; however, factors associated with a prolonged operation remain incompletely understood. In this study, we aimed to identify risk factors for a prolonged operation at a single institution.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively reviewed the data of 100 consecutive patients who underwent robot\u2010assisted pyeloplasty at our institution between April 2016 and January 2026. Patients were divided into two groups based on the operative time: the prolonged group (\u2265\u200975th percentile) and the non\u2010prolonged group (<\u200975th percentile). Clinical and anatomical variables were analyzed, and a multivariable logistic regression model was constructed to identify independent predictors of a prolonged operation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the multivariable analysis, high ureteral insertion (odds ratio: 5.6; 95% confidence interval: 1.8\u201318.3;\n p<\/jats:italic>\n \u2009=\u20090.0047), male sex (3.3; 1.2\u20139.9;\n p<\/jats:italic>\n \u2009=\u20090.024), and preoperative ureteral stenting (3.7; 1.32\u201311.2;\n p<\/jats:italic>\n \u2009=\u20090.015) were identified as significant independent predictors of a prolonged operation. Neither postoperative complication rates (\n p<\/jats:italic>\n \u2009=\u20090.33) nor surgical success rates (\n p<\/jats:italic>\n \u2009=\u20090.25) differed between the groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n High ureteral insertion, male sex, and preoperative ureteral stenting were significant independent predictors of prolonged robot\u2010assisted pyeloplasty. Nonetheless, these factors were not associated with surgical success or complication rates, confirming the safety and effectiveness of robot\u2010assisted pyeloplasty even in challenging cases.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ases.70392","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:48:36Z","timestamp":1792810116000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Prolonged Robot\u2010Assisted Laparoscopic Pyeloplasty: A Single\u2010Center Retrospective Study"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1681-0567","authenticated-orcid":false,"given":"Kohei","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izuru","family":"Shiba","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Shiono","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Shimura","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaomi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2966-6476","authenticated-orcid":false,"given":"Daisuke","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9794-1434","authenticated-orcid":false,"given":"Masatsugu","family":"Iwamura","sequence":"additional","affiliation":[{"name":"Department of Urology Tomei Atsugi Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.urology.2005.11.024","article-title":"Laparoscopic Pyeloplasty: Evolution of a New Gold Standard","volume":"67","author":"Moon D. A.","year":"2006","journal-title":"Urology"},{"issue":"4","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S0094-0143(05)70119-1","article-title":"Laparoscopic Pyeloplasty","volume":"27","author":"Janetschek G.","year":"2000","journal-title":"Urologic Clinics of North America"},{"issue":"2","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.eururo.2013.06.053","article-title":"Robot\u2010Assisted and Laparoscopic Repair of Ureteropelvic Junction Obstruction: A Systematic Review and Meta\u2010Analysis","volume":"65","author":"Autorino R.","year":"2014","journal-title":"European Urology"},{"issue":"4","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"336.e1","DOI":"10.1016\/j.jpurol.2017.12.010","article-title":"Has the Robot Caught Up? National Trends in Utilization, Perioperative Outcomes, and Cost for Open, Laparoscopic, and Robotic Pediatric Pyeloplasty in the United States From 2003 to 2015","volume":"14","author":"Varda B. K.","year":"2018","journal-title":"Journal of Pediatric Urology"},{"issue":"4","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1111\/j.1464-410X.2007.07032.x","article-title":"Robotic Anderson\u2010Hynes Pyeloplasty: 5\u2010Year Experience of One Centre","volume":"100","author":"Schwentner C.","year":"2007","journal-title":"BJU International"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2023.1209359","article-title":"The Application of Artificial Technology in Pediatric Pyeloplasty the Efficacy Analysis of Robotic\u2010Assisted Laparoscopic Pyeloplasty in the Treatment of Ureteropelvic Junction Obstruction","volume":"11","author":"Hu Z.","year":"2023","journal-title":"Frontiers in Pediatrics"},{"issue":"2","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00464-009-0578-0","article-title":"Robotic Assistance Improves Intracorporeal Suturing Performance and Safety in the Operating Room While Decreasing Operator Workload","volume":"24","author":"Stefanidis D.","year":"2010","journal-title":"Surgical Endoscopy"},{"issue":"7","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"2288","DOI":"10.1007\/s00464-010-1550-8","article-title":"Does Speed Matter? The Impact of Operative Time on Outcome in Laparoscopic Surgery","volume":"25","author":"Jackson T. D.","year":"2011","journal-title":"Surgical Endoscopy"},{"issue":"2","key":"e_1_2_10_10_1","first-page":"11087","article-title":"Operative Duration and Short Term Morbidity and Mortality Following Radical Cystectomy With Urinary Diversion","volume":"29","author":"Teplitsky S. L.","year":"2022","journal-title":"Canadian Journal of Urology"},{"issue":"2","key":"e_1_2_10_11_1","first-page":"10603","article-title":"Relationship Between Operative Duration and Perioperative Outcomes After Radical Cystectomy","volume":"28","author":"Faraj K. S.","year":"2021","journal-title":"Canadian Journal of Urology"},{"issue":"7","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"E417","DOI":"10.5489\/cuaj.2805","article-title":"Factors Predicting Prolonged Operative Time for Individual Surgical Steps of Robot\u2010Assisted Radical Prostatectomy (RARP): A Single Surgeon's Experience","volume":"9","author":"Alenizi A. M.","year":"2015","journal-title":"Journal de L'Association Des Urologues Du Canada [Canadian Urological Association Journal]"},{"issue":"1","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1089\/end.2021.0075","article-title":"Identifying Preoperative Predictors of Operative Time and Their Impact on Outcomes in Robot\u2010Assisted Partial Nephrectomy","volume":"36","author":"Krishnan N. K.","year":"2022","journal-title":"Journal of Endourology"},{"issue":"4","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.juro.2008.06.024","article-title":"Robotic Dismembered Pyeloplasty: A 6\u2010Year, Multi\u2010Institutional Experience","volume":"180","author":"Mufarrij P. W.","year":"2008","journal-title":"Journal of Urology"},{"issue":"4","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1007\/s11701-023-01559-1","article-title":"Robotic\u2010Assisted Pyeloplasty in Children: A Systematic Review of the Literature","volume":"17","author":"Esposito C.","year":"2023","journal-title":"Journal of Robotic Surgery"},{"issue":"5","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.1111\/iju.70501","article-title":"Robot\u2010Assisted vs. Laparoscopic Pyeloplasty for UPJO: A Single\u2010Center, Propensity Score\u2010Matched Analysis of Surgical Outcomes","volume":"33","author":"Mori K.","year":"2026","journal-title":"International Journal of Urology: Official Journal of the Japanese Urological Association"},{"issue":"5","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","DOI":"10.1111\/iju.70479","article-title":"Robot\u2010Assisted Pyeloplasty in Elderly Patients: A Comprehensive Retrospective Analysis of Safety and Surgical Outcomes","volume":"33","author":"Mori K.","year":"2026","journal-title":"International Journal of Urology: Official Journal of the Japanese Urological Association"},{"issue":"6","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1590\/s1677-5538.ibju.2022.0194","article-title":"Multicenter Comparative Study of Open, Laparoscopic, and Robotic Pyeloplasty in the Pediatric Population for the Treatment of Ureteropelvic Junction Obstruction (UPJO)","volume":"48","author":"Gonz\u00e1lez S. T.","year":"2022","journal-title":"International Brazilian Journal of Urology: Official Journal of the Brazilian Society of Urology"},{"issue":"1","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12894-019-0544-7","article-title":"Surgical Approaches for Treatment of Ureteropelvic Junction Obstruction\u2014A Systematic Review and Network Meta\u2010Analysis","volume":"19","author":"Uhlig A.","year":"2019","journal-title":"BMC Urology"},{"issue":"2","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1002\/rcs.70056","article-title":"Functional Outcomes After \u2018SHURUI\u2019 Single\u2010Port Robot\u2010Assisted Pyeloplasty for Uretero Pelvic Junction Obstruction: Single\u2010Centre Experience","volume":"21","author":"Li R.","year":"2025","journal-title":"International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS"},{"issue":"2","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/j.1442-2042.2012.03119.x","article-title":"Analysis of a Large Single\u2010Center Experience With Robot\u2010Assisted Pyeloplasty","volume":"20","author":"Tobis S.","year":"2013","journal-title":"International Journal of Urology"},{"issue":"3","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/j.1464-410X.1949.tb10773.x","article-title":"Retrocaval Ureter; a Case Diagnosed Pre\u2010Operatively and Treated Successfully by a Plastic Operation","volume":"21","author":"Anderson J. C.","year":"1949","journal-title":"British Journal of Urology"},{"issue":"2","key":"e_1_2_10_23_1","first-page":"168","article-title":"Robot\u2010Assisted Pyeloplasty for Ureteropelvic Junction Obstruction: Experience From a Tertiary Referral Center","volume":"71","author":"Masieri L.","year":"2019","journal-title":"Minerva Urologica e Nefrologica [the Italian Journal of Urology and Nephrology]"},{"key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.urology.2015.12.050","article-title":"Long\u2010Term Outcomes of Robot\u2010Assisted Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction","volume":"90","author":"Hopf H. L.","year":"2016","journal-title":"Urology"},{"issue":"6","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/bju.12652","article-title":"One\u2010 Vs 4\u2010Week Stent Placement After Laparoscopic and Robot\u2010Assisted Pyeloplasty: Results of a Prospective Randomised Single\u2010Centre Study","volume":"113","author":"Danuser H.","year":"2014","journal-title":"BJU International"},{"issue":"1","key":"e_1_2_10_26_1","first-page":"45","article-title":"Robot\u2010Assisted Laparoscopic Pyeloplasty in Adults: A Comparison Analysis of Primary Versus Redo Pyeloplasty in a Single Center","volume":"18","author":"Dirie N. I.","year":"2020","journal-title":"Urology Journal"},{"issue":"5","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"606","DOI":"10.23736\/S2724-6051.24.05834-8","article-title":"Primary Pyeloplasty for Uretero\u2010Pelvic Obstruction in the USA Adult Population With or Without Double\u2010J Indwelling Ureteral Stents. Insurance Claims Data on Contemporary Time to Removal Trends, Perioperative Complications, Health Care Costs, and re\u2010Intervention Rates","volume":"76","author":"Del Giudice F.","year":"2024","journal-title":"Minerva Urology and Nephrology"},{"issue":"3","key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.4103\/ua.ua_101_23","article-title":"Minimally Invasive Versus Open Pyeloplasty in Pediatric Population: Comparative Retrospective Study in Tertiary Centre","volume":"16","author":"Alqarni N. H.","year":"2024","journal-title":"Urology Annals"},{"issue":"1","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00345-025-05782-3","article-title":"Safety of Robotic\u2010Assisted Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction in Older Patients","volume":"43","author":"Song J. J.","year":"2025","journal-title":"World Journal of Urology"},{"issue":"19","key":"e_1_2_10_30_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11195651","article-title":"A Comparative Analysis of Robot\u2010Assisted Laparoscopic Pyeloplasty in Pediatric and Adult Patients: Does Age Matter?","volume":"11","author":"Kang B.","year":"2022","journal-title":"Journal of Clinical Medicine"},{"issue":"3","key":"e_1_2_10_31_1","first-page":"E59","article-title":"Robotic\u2010Assisted Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction A Retrospective Review of a High\u2010Volume Canadian Center","volume":"18","author":"Ordon M.","year":"2024","journal-title":"Journal de L'Association Des Urologues Du Canada"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.urology.2022.12.070","article-title":"Robot\u2010Assisted Laparoscopic Pyeloplasty: Experience of a Single Pediatric Institution, Including Long\u2010Term and Safety Outcomes","volume":"176","author":"Lai A.","year":"2023","journal-title":"Urology"}],"container-title":["Asian Journal of Endoscopic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70392","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ases.70392","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70392","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:48:48Z","timestamp":1792810128000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ases.70392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ases.70392"],"URL":"https:\/\/doi.org\/10.1111\/ases.70392","archive":["Portico"],"relation":{},"ISSN":["1758-5902","1758-5910"],"issn-type":[{"value":"1758-5902","type":"print"},{"value":"1758-5910","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-07-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70392"}}