Is robot-assisted surgery as effective as open surgery for vesicoureteral reflux?
For children with vesicoureteral reflux (VUR, where urine flows backward from the bladder toward the kidneys) who need surgery, the traditional operation is open ureteral reimplantation, which means making an open incision to reposition the ureter. Robot-assisted laparoscopic ureteral reimplantation (RALUR) is a newer, minimally invasive version of the same operation. The short answer from the available evidence is that the two approaches appear to have similar success rates, though they differ in operating time and recovery details 268.
What the research says
A 2018 systematic review and meta-analysis pooled six studies with 7,122 children who had primary VUR and compared robot-assisted laparoscopic ureteral reimplantation (RALUR) with open ureteral reimplantation (OUR). It found no significant difference between the groups in success rate, complications, estimated blood loss, or postoperative pain medication use. RALUR did take significantly longer to perform (about 67 more minutes on average) but was linked to fewer days in the hospital and shorter time with a Foley catheter 6.
What to ask your doctor
- What are the success rates for robot-assisted versus open ureteral reimplantation at your center specifically?
- Given my child's age, weight, and reflux grade, which approach do you recommend and why?
- How does the longer operating time with robot-assisted surgery affect my child's overall recovery?
- What are the risks of complications in the short term and long term for each approach?
- Will my child need antibiotic prophylaxis after surgery, and what are the trade-offs?
This question is drawn from common patient questions about Urology and answered using cited medical research. We do not provide individualized advice.