Surgical procedure and efficacy of KangDuo robot-assisted pyeloplasty for horseshoe kidney.

BACKGROUND

Ureteropelvic junction obstruction (UPJO) in horseshoe kidney (HSK) is surgically challenging because of aberrant anatomy. Robot-assisted pyeloplasty may overcome some limitations of laparoscopy, but data on the Chinese-developed KangDuo (KD) robotic system in HSK are lacking. This study evaluated the surgical procedure and efficacy of KD robot-assisted pyeloplasty for UPJO in HSK.

METHODS

This retrospective study included 14 adult patients with HSK and UPJO who underwent KD robot-assisted dismembered pyeloplasty between March 2021 and December 2025. Seven procedures used KD-SR1000 and seven used KD-SR2000. Perioperative outcomes, complications, renal function, and follow-up data were analyzed.

RESULTS

All 14 procedures were completed successfully without conversion or intraoperative complications. Preoperatively, 12 patients (85.7%) presented with flank pain, 7 patients (50.0%) had concomitant renal calculi, and 5 patients (35.7%) required preoperative stent insertion. Mean operative time was 200.7 minutes, and median blood loss was 20 mL. One postoperative urinary tract infection (Clavien-Dindo II) occurred. Postoperatively, mean serum creatinine improved from 77.8±17.3 to 69.6±16.6 μmol/L, and mean eGFR improved from 93.8±14.9 to 104.1±13.2 mL/min/1.73 m2.All procedures achieved technical success, with no need for reintervention during follow-up.

CONCLUSIONS

KD robot-assisted pyeloplasty is safe and feasible for UPJO in HSK and provides satisfactory mid-term outcomes. Larger prospective comparative studies are warranted to confirm these findings and assess cost-effectiveness.