Robotic Pyeloplasty and Ureteric Re-implantation
Robotic pyeloplasty and ureteric re-implantation are reconstructive procedures that address specific structural problems in the urinary tract. Both are performed to restore normal urine flow and protect kidney function — not to treat cancer.
Robotic assistance is used for both procedures at this practice. The operations require precise dissection and careful suturing in relatively confined spaces, and the magnification and instrument control that robotic systems provide can be helpful in that context.
Robotic Pyeloplasty
What it treats
Pyeloplasty is the operation for pelviureteric junction (PUJ) obstruction — a narrowing or blockage at the point where the kidney drains into the ureter. When urine cannot drain freely from the kidney, pressure builds in the collecting system over time. This can cause pain, recurrent infections, and — if left untreated — progressive loss of kidney function.
PUJ obstruction can be present from birth and discovered incidentally on imaging, or it can present later with symptoms. It can also be caused by crossing blood vessels that compress the ureter at the PUJ, which can often be identified on pre-operative imaging and may influence the surgical approach.
What the operation involves
Robotic pyeloplasty is performed under general anaesthesia through small keyhole incisions. The obstructed segment of the ureter at the PUJ is excised and the kidney pelvis is reconstructed and reconnected to the ureter in a way that allows free drainage. A temporary internal stent (a JJ or double J stent) is placed at the time of surgery to support healing and is removed a few weeks later, usually in a brief outpatient procedure.
The robotic system is controlled entirely by the surgeon, with an assistant present at the bedside throughout the operation. Hospital stay is typically one to two days.
Recovery
Most patients are mobile within a day of surgery. The internal stent may cause some urinary frequency or mild discomfort until it is removed — this is normal and temporary. Return to desk work is usually possible within two to three weeks. Strenuous activity is restricted for six weeks.
Follow-up imaging is performed after recovery to confirm that drainage has improved and the reconstruction is functioning well
Ureteric Re-implantation
What it treats
Ureteric re-implantation is an operation used when the lower end of the ureter needs to be repositioned into the bladder. In adults, this may be considered for selected cases of distal ureteric obstruction, scarring, injury after previous pelvic surgery, or persistent reflux causing recurrent infections or kidney damage.
The goal of surgery is to restore normal urine drainage while protecting kidney function and reducing the risk of recurrent infection or ongoing obstruction. Where reflux is the indication, the operation creates a tunnel at the new ureteric insertion point — this acts as a one-way valve, allowing urine to pass from the ureter into the bladder while preventing backflow.
What the operation involves
Robotic ureteric re-implantation is performed under general anaesthesia through small keyhole incisions. The ureter is carefully detached from its existing insertion point and reattached to the bladder in a way that creates a tunnel — this tunnel acts as a one-way valve, allowing urine to pass from the ureter into the bladder while preventing reflux. A temporary stent may be placed to support healing.
Hospital stay is typically one to two days.
Recovery
Recovery is similar to pyeloplasty. Most patients are mobile within a day. There may be some urinary frequency initially. Return to desk work is usually possible within two to three weeks, with strenuous activity restricted for six weeks.
Follow-up imaging is performed after recovery to assess healing and confirm satisfactory drainage or resolution of reflux, depending on the indication for surgery.
Risks and considerations
Both procedures carry the standard risks of minimally invasive surgery — bleeding, infection, injury to surrounding structures, and anaesthetic risks. Specific to these reconstructive operations is the possibility that the repair does not heal as intended, which may require further assessment or repeat intervention. These risks are uncommon but will be discussed in full at your consultation.
To discuss whether robotic pyeloplasty or ureteric re-implantation is appropriate for your situation, contact the rooms to arrange a consultation.
Clinical note: This page provides general information and is not a substitute for individual medical advice. Treatment decisions should be based on personalised assessment and discussion of options.
Last reviewed: May 2026