Best Robotic Pyeloplasty in Ahmedabad, India

Pelvi-Ureteric Junction (UPJ) obstruction treatment has evolved dramatically with availability of robotic surgery in India. This advanced technique offers superior precision, minimal pain, and rapid recovery compared to traditional open or laparoscopic surgery.

Dr. Rohan Patel, is recognized as one of the best robotic surgeons in India for robotic pyeloplasty using the Da Vinci Xi system for both adults and children. He is currently associated with Ananta Urology Clinic and Apollo hospital, Ahmedabad.

Whether you’re seeking relief from hydronephrosis, recurrent infections, or kidney pain from PUJ Obstruction, our advanced Da Vinci Robotic Surgery approach ensures world-class results, transparent costs, and comprehensive postoperative care.

Best Hospital for Robotic Pyeloplasty in India. Why Choose Us?

At our robotic surgery centre in Ahmedabad, India we specialise in robotic pyeloplasty for UPJ obstruction, using the latest 4th generation Da Vinci Xi system. Here’s why many patients from India and abroad choose us:

What is UPJ (Pelvi-Ureteric Junction) Obstruction?

Pelvi Ureteric Junction Obstruction (PUJO) also called UPJ obstruction occurs when the flow of urine is blocked or slowed at the junction where the renal pelvis meets the ureter. This disease may be congenital (present at birth) or acquired later in life due to scarring, stones or external blood-vessel compression. Over time, long term PUJ obstruction can lead to hydronephrosis (kidney swelling) and loss of kidney function.

In India, diagnosis is often made during antenatal ultrasound (for infants) or when flank pain, recurrent UTIs or stones occur in older children/adults.

PUJO Symptoms

Symptoms of PUJO differs by age group at the time of patient presentation:

Infants & Children

Most ureteropelvic junction obstructions are diagnosed at birth or antenatal during maternal ultrasound (USG). It is caused by abnormal development of the ureter or kidney during fetal development. The other cause of UPJO is that of an abnormal location of blood vessel (usually an artery) going across the UPJ and causing compression. Most common symptoms of UPJO in a child if not diagnosed at birth is:

• Bed-wetting, failure to thrive
• Recurrent urinary tract infections
• Prenatal ultrasound showing hydronephrosis
• Abdominal mass (rare)

Adults

Congenital UPJ obstruction diagnosis is rare in adults and is often diagnosed at 20 to 40 years. It is usually a secondary UPJO that can happen after surgery, kidney stones, recurrent UTI’s. Patient usually present with:

• Side or abdominal pain (especially after drinking fluids)
• Repeated kidney stones or urine infections
• Blood in urine
• Reduced kidney function on imaging

If you observe any of these symptoms or signs of PUJO, especially with imaging showing hydronephrosis, you should consult a urologist near you experienced in robotic reconstructive surgery.

How is UPJ Obstruction Diagnosed?

Diagnosis of UPJO involves a combination of imaging and functional tests by an urologist:

• Ultrasound of Abdomen – assesses kidney swelling and drainage.
• DTPA/MAG3 renogram – evaluates the degree of obstruction and kidney function.
• CT/MR urogram – provides detailed anatomy for planning, especially before robotic surgery.
• Blood tests, urine culture – to rule out infection and check general kidney health.

Getting a diagnosis early helps preserve kidney function and simplifies repair.

PUJO Treatment

PUJO treatment depends on the age at presentation. During the first 18 months, it usually resolves on its own. After 18 months of age and in adults it usually requires surgical correction in the form of pyeloplasty. During the first 18 months of age, your child’s urologist will schedule regular ultrasounds and scans to make sure the UPJ obstruction isn’t causing any harm.
If your child’s urine flow doesn’t improve and the obstruction is still there after the child is 18 months old, they’ll likely need an pyeloplasty. This is usally done via open, laparoscopic or robotic surgery approach.

OPEN PYELOPLASTY:

During open pyeloplasty, a urologist will use a surgical knife (scalpel) to make one large cut (incision) in abdomen or flank to remove the obstructing part of the ureter and reattach the normal ureter to their kidney with a wider opening. An open pyeloplasty usually takes a few 2-3 hours to complete and has about a 95% success rate.

ROBOTIC PYELOPLASTY:

In some cases, the urologist surgeon may be recommend a minimally invasive technique for pyeloplasty with a surgical robot to treat UPJ obstruction. In robotic pyeloplasty, 2-3 small incision are made and a surgical robot is used to operate. A minimally invasive pyeloplasty has a comparable success rate to an open pyeloplasty with the advantage of being minimally invasive, less bleeding, pain and infection and early recovery.

ENDOPYELOTOMY:

In endopyelotomy the surgeon inserts an endoscope through your urethra or through an small incision in the back to see the obstruction. They’ll then insert a guide wire through a channel in the endoscope and use it to cut the obstruction using either a laser or electrocautery and insert a DJ stent. The stent will remain for a few weeks. Endopyelotomy has a lower success rate.

Robotic (Open vs Laparoscopic vs Endopyelotomy)
Detailed Comparison

1. Robotic Pyeloplasty

Pros: Minimal incision, fastest recovery, excellent operative view, less pain, home sooner.

Cons: Requires specialist centre, slightly higher equipment cost.

2. Open Pyeloplasty

Pros: Long-standing gold standard, widely available.

Cons: Larger incision, longer stay, slower return to full activity.

3. Laparoscopic Pyeloplasty

Pros: Smaller incisions than open, shorter stay.

Cons: Surgical suturing skill required, somewhat longer operative time compared to robotic.

4. Endopyelotomy / Balloon Dilation

Pros: Least invasive, minimal hospital stay.

Cons: Lower success rates, less preferred in complex anatomy or crossing vessels. ( Urology & Nephrology Journal)

Our Recommendation: For most adults and children with significant UPJ obstruction and preserved kidney function, robotic pyeloplasty offers the best balance of safety, outcome and recovery.

What to Expect during Robotic Pyeloplasty – The Patient Journey

Before Surgery

• Detailed evaluation: imaging, kidney scan, blood & urine tests
• Pre-op counselling: risks, benefits, cost, hospital stay
• Pre-habilitation: hydration, nutrition, special instructions

Day of Surgery

• General anaesthesia
• 3-4 small (1-2 cm) incisions, robotic docking
• Removal of blocked segment, reconstruction, placement of ureteric stent
• Transfer to recovery / ward

Post-Op & Follow-Up

• Typically 1-2 nights hospital stay
• Pain management with minimal narcotics
• Discharge instructions: fluids, avoid heavy lifting, light activity
• Stent removal: usually at 4-6 weeks
• Follow-up imaging: usually at 3-6 months, then annually to monitor drainage and kidney function

Recovery Timeline

• Day 0–1: Observe in hospital, minimal discomfort
• Week 1: Light activities, no heavy lifting
• Week 2–4: Return to office work, moderate activity
• Week 4–6: Full activity, sports/light exercise
• After 6 weeks: Most patients resume normal life

Risks & Success Rates of Robotic Pyeloplasty

Success Rates of Robotic Pyeloplasty

Studies show robotic pyeloplasty success in the 95-98% range when performed in experienced centres. At our centre we have a success rate of more than 95% with robotic pyeloplasty which is comparable to international standards.

Complicaions of Robotic Pyeloplasty

• Urinary leakage from repair site
• Infection or bleeding (rare)
• Recurrence of obstruction (<5%)
• Risks associated with general anaesthesia

At our centre, our dedicated robotic urology surgeon goes through pre-op risk assessment and ensure safety protocols for your best possible outcome.