Open Access
ARTICLE
Robotics in functional and reconstructive urology: evolutionary institutional experience and current attitudes amongst practicing urologists
Rohan G. Bhalla1, Sasha J. Vereecken1,*, Nate Coddington2, Ty T. Higuchi1, Brian J. Flynn1
1 Division of Urology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
2 AdventHealth Medical Group Urology, Greenwood Village, CO, USA
* Corresponding Author: Sasha J. Vereecken. Email: 
(This article belongs to the Special Issue: Advances in Robot-Assisted Urological Surgery: Innovations, Outcomes, and Future Perspectives)
Canadian Journal of Urology https://doi.org/10.32604/cju.2026.076096
Received 14 November 2025; Accepted 11 March 2026; Published online 02 June 2026
Abstract
Background: The use of robotic-assisted laparoscopic (RAL) surgery in functional and reconstructive urology (FRU) has exponentially grown and has become standard of care over the past decade. We aimed to compare our experience adopting RALsurgery in FRU with current practice patterns and to discuss the implications of the RAL platform for the future of genitourinary reconstructive surgery (GURS) training. Methods: We reviewed case logs of two GURS urologists and identified RAL cases from 2012 to 2024. Cases were categorized into: lower urinary tract (LUT), upper urinary tract (UUT), urogynecology and reconstructive pelvic surgery (URPS), fistula, extirpative, and gender affirmation. Changes in volume and distribution were evaluated over time. A REDCap survey was circulated amongst practicing urologists, asking about their experience regarding RAL-FRU surgery. Results: A total of 1083 surgeries were captured: 165 LUT, 314 UUT, 437 URPS, 16 fistula, 94 extirpative, and 57 gender affirmation. The annual number of RAL-FRU cases increased from 23 (2012) to 158 (2024), with the biggest change seen in UUT reconstruction (4.3% to 36.1%). A total of 108 surveys were completed. The majority of respondents had been practicing for less than 10 years (59%) and in academia (57%). Of the respondents, 31% performed at least 10 RAL-FRU cases annually. The most common cases were robotic pyeloplasty (55%) and ureteral reconstruction (54%). Surgeons involved in post-graduate training reported they strongly agreed or agreed with reporting RAL-FRU cases for GURS fellows. Conclusions: The RAL platform was rapidly adopted in FRU surgery over the past decade, particularly in UUT reconstruction. Educators should aim to incorporate robotics training for the next generation of GURS surgeons.
Keywords
robotic-assisted laparoscopic surgery; functional and reconstructive urology; genitourinary reconstructive surgery; urogynecology and reconstructive pelvic surgery; upper urinary tract reconstruction; lower urinary tract
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