Kidney Blockage Surgery

Learn about surgery for ureteropelvic junction blockage and understand your options

Get back in the flow

Your kidneys filter blood to remove waste and extra water that is then sent through the ureter tubes to your bladder as urine. When the connection point between the kidney and ureter tube (called the ureteropelvic junction or UPJ) becomes blocked, urine builds up in the kidney, which may cause pain or infection.

Kidney blockage at the UPJ is typically congenital, meaning children are born with it. About one in 1,500 children are born with this problem. Although less common, a UPJ obstruction can also develop in adults due to surgery, kidney stones or swelling in the upper urinary tract. 

Symptoms of UPJ blockage may include back pain, kidney stones, vomiting, infection with fever, and bloody urine.¹

Understanding your options

To allow urine to flow again, doctors may need to remove the UPJ blockage and expand the connection between the kidney and ureter. There are three main surgical options for a UPJ obstruction: endopyelotomy, open pyeloplasty, and minimally invasive pyeloplasty. 

In an endopyelotomy procedure, a doctor threads an instrument up through the bladder and ureter into the kidney junction to cut or burn away blockages.

During pyeloplasty surgery, the surgeon detaches the ureter and removes any blockage, such as a too-narrow junction, scar tissue, or kidney stones. The surgeon then reattaches the ureter to the kidney so that urine can drain into the bladder. 

Surgeons can perform pyeloplasty using open surgery or a minimally invasive approach. Traditional open surgery requires an incision long enough for surgeons to look directly at the kidney, junction, and ureter while performing the surgery using hand-held tools. 

There are two minimally invasive pyeloplasty options: laparoscopic surgery and robotic-assisted surgery (possibly with da Vinci technology). Both are both performed through a few small incisions. To perform a laparoscopic pyeloplasty, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

How the da Vinci system works Surgeons can perform pyeloplasty surgery using da Vinci technology. With a da Vinci system, your surgeon sits at a console next to your child or you and operates using tiny, fully wristed instruments. A camera provides a high-definition, 3D magnified view inside the body. The da Vinci system translates every hand movement your surgeon makes in real time to bend and rotate the instruments with precision.

It’s important to remember that Intuitive does not provide medical advice. After discussing all options with your doctor, only you and your doctor can determine whether surgery with da Vinci technology is appropriate for your situation. You should always ask your surgeon about his or her training, experience, and patient outcomes.

What are the outcomes of surgery with the da Vinci system? 

Be sure to talk with your surgeon about the surgical outcomes he or she delivers by using the da Vinci system, as every surgeon's experience is different. For example, ask about:

• Length of hospital stay
• Complication rate
• Rate of returning to the hospital within 30 days of surgery 
• Reoperation rate
• Transfusion and/or blood loss
• Chance of changing to an open procedure
• Length of operation
• Mortality rate

There are additional outcomes of surgery that you may want to talk with your doctor about. Please ask him or her about all important outcomes of surgery. All surgery involves risk. You can read more about associated risks of pyeloplasty surgery here.

Disclosures and Important Safety Information

Questions you can ask your doctor

• What options are available to address kidney blockage? Which is best for me and why?
• What are the differences between open, laparoscopic, and robotic-assisted surgery?
• Should I get a second opinion?
• What am I likely to experience after surgery?
• If I decide to have surgery, how can I prepare for it?
• Can you tell me about your training and experience with da Vinci robotic-assisted surgery?
• What am I or my child likely to experience after surgery?

 

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Resources for learning more

Pyeloplasty surgery brochure Read this brochure to help enable meaningful and informed conversation with your doctor about different options. About your options

Urologic surgery with the da Vinci system Robotic-assisted surgery with da Vinci technology is used in many different types of procedures by urology surgeons. About the specialty

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^{1. What Is Ureteropelvic Junction Obstruction? Urology Care Foundation. Web. 14 May 2020} 

Disclosures and Important Safety Information

Surgical Risks

Risks associated with pyeloplasty (surgery for a urinary blockage) include infection of the kidney, leaking of urine, narrowing of the ureter, bowel injury, kidney stones, blockage or movement of the stent, blood in the urine, prolonged leaking of urine.

Important Safety Information

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options and associated risks in order to make an informed decision. 

Serious complications may occur in any surgery, including da Vinci surgery, up to and including death. Serious risks include, but are not limited to, injury to tissues and organs and conversion to other surgical techniques which could result in a longer operative time, and/or increased complications. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.intuitive.com/safety.

Individuals' outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience.

Da Vinci Xi System Precaution Statement

The demonstration of safety and effectiveness for the specific procedure(s) discussed in this material was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of cancer (overall survival, disease-free survival, local recurrence), or treatment of the patient’s underlying disease/condition. Device usage in all surgical procedures should be guided by the clinical judgment of an adequately trained surgeon.

Medical Advice and Locating a Doctor

Patients should talk to their doctor to decide if da Vinci surgery is right for them. Other options may be available and appropriate. Only a doctor can determine whether da Vinci surgery is appropriate for a patient’s situation. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision.

Surgeons who utilize the da Vinci system can be found using the Surgeon Locator. Intuitive Surgical only provides surgeons with training on the use of the da Vinci system but does not certify, credential, or qualify the surgeons listed in the Surgeon Locator.

Product names are trademarks or registered trademarks of Intuitive Surgical or their respective owners. See www.intuitive.com/trademarks.

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