Robotic pyelolithotomy is keyhole surgery in which the renal pelvis, the funnel-shaped collecting area of the kidney, is opened so a large stone can be lifted out directly, after which the kidney is repaired with fine stitches. Most kidney stones are better treated with other options (ureteroscopy or PCNL), so robotic stone surgery is reserved for specific situations.
TREATMENTS
Robotic Pyelolithotomy
When Is Robotic Pyelolithotomy Considered?
We only consider a robotic approach in selected circumstances, such as:
• A large stone (> 2 cm) or staghorn stones, where removal may avoid multiple endoscopic procedures
• A stone together with PUJ obstruction, so the blockage can be repaired (pyeloplasty) and the stone removed in a single operation
• Abnormal kidney anatomy, such as a horseshoe or pelvic kidney, where standard ureteroscopy or percutaneous access has been tried or deemed unsafe
How the Operation Is Performed
• Keyhole robotic access: through a few small incisions, the robotic instruments expose the kidney and renal pelvis under magnified 3D vision
• Stone removal: the pelvis is opened and the stone is freed and placed in a retrieval bag so it can be removed intact, and a flexible telescope can inspect the inside of the kidney for fragments
• Repair and drainage: the pelvis is closed with fine dissolving stitches, an internal stent (a soft plastic tube from kidney to bladder) protects healing, and a small drain may sit near the kidney for a day or two
• Combined pyeloplasty: when the PUJ is obstructed, the narrowed segment is removed and the junction re-joined during the same operation
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• Residual stone fragments that may need ureteroscopy, shock wave treatment or simple observation
• Urine leak from the repair
• Bleeding, urinary infection or sepsis (rare)
• Stent symptoms such as urinary frequency, urgency and flank twinges until the stent is removed
• Rarely, conversion to open surgery or injury to nearby organs
Recovery at a glance: Usually 1 to 3 nights in hospital; the internal stent is removed after about 4-6 weeks, with desk work possible after 1-2 weeks and heavier activity from 4-6 weeks.
1
Planning
A CT scan maps the stone, the drainage anatomy and kidney function, urine is checked for infection, and we confirm that endoscopic options are not the better choice for your particular stone.
2
The Procedure
Under general anaesthesia, the renal pelvis is opened, stone removed and kidney repaired. It is combined with pyeloplasty if needed.
3
Recovery and Stent Removal
Most patients go home within a few days; imaging confirms the kidney is clear and the internal stent is removed after around 4-6 weeks.
4
Stone Prevention
The stone is analysed and, together with blood and urine tests, can be used to help guide prevention with fluid and dietary advice. This is combined with periodic imaging so any new stones are found early.
Our Approach
