Early Experience of Robotic-Assisted Reconstructive Operations in Pediatric Urology

Objectives: Laparoscopic pyeloplasty and ureteric reimplantation are complex urologic operations requiring delicate surgical skill. The use of a robot may provide benefits in performing these reconstructive operations. In this article, we report our early experience in the use of the robot in pediatric urologic operations. Methods: Children who underwent robotic-assisted reconstructive urologic operations were reviewed and analyzed. Results: From November 2005 to April 2008, 8 children underwent robotic-assisted reconstructive urologic operations. Three children had extravesical ureteral reimplantation performed for vesicoureteric reflux (VUR), and 5 children had pyeloplasty performed for pelvic-ureteric junction obstruction. There was no conversion to open procedure and no intraoperative complication. The operative time ranged from 105 to 420 minutes (mean, 219). Postoperatively, 1 patient had urinary retention and 1 patient had postoperative fever. Hospital stay ranged from 3 to 10 days (mean, 4.8). Mean follow-up time was 38 months (range, 17-46). VURs were resolved for the 2 children with simple VUR and was downgraded for the child with duplex kidney. All patients who underwent pyeloplasty showed satisfactory urinary drainage after the operation. Conclusions: From this early experience, robotic-assisted urologic operations in children were safe and feasible. It was particularly useful in reconstructive operations that required precise suturing, such as ureteric reimplantation and pyeloplasty.