To evaluate the clinical outcomes of robot-assisted laparoscopic pyeloplasty (RALP) for the treatment of ureteropelvic junction obstruction (UPJO) in infants under three months of age.

A retrospective analysis was conducted on clinical data of infants under three months of age who underwent RALP for UPJO at our institution between June 2019 and December 2022. A total of 67 cases were included, all presenting with unilateral hydronephrosis. The clinical data of all patients were collected, including basic information, perioperative data, and postoperative outcomes. Preoperative assessments included ultrasound, magnetic resonance urography (MRU), and diuretic renography. Postoperative evaluations were performed using ultrasound and renal function evaluation to assess the improvement in hydronephrosis and renal function recovery.

All surgeries were performed by the same surgeon using the Da Vinci surgical system, and no conversions to open surgery were required. The mean age of the patients was 1.51 ± 0.58 months. The average surgical duration was 104.31 ± 12.32 minutes, with an estimated intraoperative blood loss of 10.73±4.04 ml, and the mean hospital stay was 5.46 ± 0.72 days. Two patient developed recurrence of hydronephrosis postoperatively, which was successfully managed with endoscopic balloon dilation and extended indwelling double-J stent placement. The remaining patients had a smooth postoperative recovery, with no recurrence observed during follow-up.

RALP is a safe and feasible option for the treatment of UPJO in infants under three months of age, providing excellent clinical outcomes.