Robotic-assisted laparoscopic ureterocalicostomy (RALUC): a systematic review of its applications

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PURPOSE: Ureterocalicostomy refers to the anastomosis between the lower pole calyces and the ureter. Robotic-assisted laparoscopic ureterocalicostomy (RALUC) is gaining ground, ultimately. The current systematic review summarizes all applications of RALUC in both adults and children. METHODS: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines, three databases (PubMed, Scopus and Cochrane) were screened, from their inception to 16 February 2025. The following search string was used: robotic AND (ureterocalicostomy OR ureterocalicostomies OR ureterocalycostomy OR ureterocalycostomies). RESULTS: Eight studies fulfilled all inclusion criteria and were finally considered for qualitative synthesis. The rate of patients who had undergone previous pyeloplasty ranged in included studies from 20% to 100%, while the rate of patients who had undergone a nephrostomy tube placement before the ureterocalicostomy ranged from 38% to 100%. Total operative time ranged from 157.6 (90-240) to 272 min, while estimated blood loss ranged from 27.5 (10-75) to 115 (50-200) mL. Reoperation rates ranged from 0% to 50%, while the success rates ranged from 66.7% to 100%. Finally, taking into consideration the Clavien-Dindo Classification System, the Grade I-II complications ranged from 0% to 40%, while the Grade III-IV ones ranged from 0% to 20%. CONCLUSION: RALUC is a feasible, safe and efficient procedure for patients with complicated ureteropelvic junction obstruction. The implementation of higher-quality studies on larger samples, including comparative ones and randomized controlled trials, is crucial in order to draw safer conclusions.

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