First Robotic Reconstructive Urology Experience in Indonesia: Early Outcomes from a National Center

Abstract

Objective: Robotic reconstructive urology is well described on the da Vinci system but rarely on other platforms, and seldom from low- and middle-income countries. We report an initial experience with the Edge MP1000 and Toumai multiport systems at a national referral center. Methods: We retrospectively reviewed 7 consecutive adults who underwent robotassisted reconstruction for benign ureteral or fistulous disease between October 28, 2024, and July 31, 2025. Outcomes were docking and operative times, conversion, estimated blood loss (EBL), length of stay (LOS), 30-day Clavien–Dindo complications, and early functional success, defined as freedom from ureteral stents and nephrostomy tubes with imaging-confirmed patency. Results: All 7 procedures were completed robotically. The cohort comprised 3 benign ureteral strictures, 1 combined distal stenosis reconstructed with a Boari flap, 2 ureterovaginal fistulas, and 1 vesicouterine fistula. The median age was 39 years, docking time 10 minutes, operative time 250 minutes, EBL 50 mL, and LOS 6 days. One Clavien–Dindo grade II complication occurred, with no higher grade, no reoperation, and no death. Every patient achieved early functional success at a median follow-up of 5 months, hydronephrosis resolved in all 5 affected kidneys, and renal function was stable in 6 patients. Docking and operative times fell in the later cases, but platform and case complexity changed together. Conclusion: In this small single-center series, benign urinary tract reconstruction was completed safely on the Edge MP1000 and Toumai systems. These findings are preliminary and should not be generalized. Longer follow-up is needed to establish durability. Cite this article as: Soeroto AA, Maulana MAI, Lionardi SK, et al. First robotic reconstructive urology experience in Indonesia: Early outcomes from a national center. Urol Res Pract. 2026;52, doi:10.5152/ tud.2026.26062