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Robotic surgery guide

Robotic pyelolithotomy

Removal of a large kidney stone by opening the kidney’s collecting system (renal pelvis) robotically, often in a single procedure.

Kidney Stones — medical illustration

Illustration: BruceBlaus, CC BY 3.0, via Wikimedia Commons

Surgery time

About 2–3 hours

Hospital stay

Usually 1 night

Ureteral stent

About 2–6 weeks

Back to desk work

Usually 1–2 weeks

Typical ranges for most patients. Your own plan may differ — Dr. Pooli will review what to expect with you.

Who it’s for

Most kidney stones are treated without incisions, using ureteroscopy and laser or shock wave lithotripsy. Robotic pyelolithotomy is reserved for selected patients — for example a large stone in the renal pelvis, a stone together with a UPJ blockage that also needs repair (pyeloplasty), or anatomy that makes endoscopic treatment difficult.

How it works

Through small incisions, the renal pelvis is opened, the stone is lifted out whole, and the opening is closed with fine stitches. A flexible scope may be passed into the kidney to look for and remove smaller fragments. If a blockage is present, it can be repaired at the same time.

The stone is sent for analysis so we can recommend diet and medication to help prevent new stones.

What to expect

Before, during and after surgery

Step 1

Before surgery

  • CT scan to map the stone
  • Urine culture and treatment of any infection
  • Stop blood thinners as instructed
  • Nothing to eat or drink after midnight unless told otherwise

Step 2

During surgery

  • General anesthesia, lying on your side
  • 3–5 small incisions
  • Stone removed through the renal pelvis
  • Stent placed while the kidney heals

Step 3

After surgery

  • Walking the same day
  • Catheter usually removed before going home
  • Stent removed in the office in about 2–6 weeks
  • Drink plenty of fluids
  • Stone analysis, metabolic testing and a prevention plan at follow-up

Possible risks

Robotic surgery is generally safe, and serious problems are uncommon. As with any operation, risks can include:

  • Small leftover stone fragments
  • Urine leak
  • Bleeding
  • Infection
  • Stent discomfort
  • Narrowing of the repaired area (rare)

When to call us

  • Fever of 100.4°F (38°C) or higher
  • Severe flank pain
  • Unable to urinate
  • Heavy bleeding or clots in the urine
  • Any other symptom that worries you

Call (424) 529-6755. For chest pain, trouble breathing or other emergencies, call 911.

This page is general education and is not a substitute for medical advice. Every patient is different; your surgical plan, recovery timeline and instructions will be personalized at your consultation.

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