Assistant port is unnecessary for robotic-assisted laparoscopic pyeloplasty in children: a comparative cohort study

Danacıoğlu, Yavuz Onur; Keser, Ferhat; Polat, Salih; Gunaydin, Bilal; Çömez, Yusuf İlker; Silay, Mesrur Selçuk

doi:10.1007/s00383-022-05158-3

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…In the robotic setting, a few challenges need to be addressed, with the classical procedure well described and proven effective [2]. With a three ports setting without assistant port, dissection and identification of the anatomy might be cumbersome [3]. Hinging stitches are most helpful to provide traction on structures, as demonstrated on the video.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted pyeloplasty: How to deal with anatomic variants? A step-by-step video presentation

Jamaer¹,

Berquin²,

Claeys³

et al. 2023

Journal of Pediatric Urology

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Section: Discussionmentioning

confidence: 99%

Robot-assisted pyeloplasty: How to deal with anatomic variants? A step-by-step video presentation

Jamaer¹,

Berquin²,

Claeys³

et al. 2023

Journal of Pediatric Urology

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“…Of note, new hidden incision endoscopic surgery (HIdES) technique aims to eliminate visible scarring, placing the robotic working port and camera port below the line of a Pfannenstiel incision, while a second working port is placed infraumbilically [29]. A recent comparative cross-sectional study [30] using da Vinci Xi Surgical System® compared the efficacy, safety, and cosmetic outcomes of three-port RALP with the conventional fourport RALP method, showing that the first can be applied with similar success and safety to the latter in all patients, including infants. Three-port RALP involves the use of a percutaneous hitch stitch to hold the renal pelvis and a 14-G angiocatheter via the percutaneous route to place the double-J stent.…”

Section: Surgical Technique and Operative Timementioning

confidence: 99%

Robotic-assisted pyeloplasty in children: a systematic review of the literature

Esposito¹,

Cerulo²,

Lepore³

et al. 2023

J Robotic Surg

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Robotic pyeloplasty has become a natural progression from the development of open, then laparoscopic procedures to treat pediatric patients with ureteropelvic junction obstruction (UPJO). Robotic-assisted pyeloplasty (RALP) is now considered a new gold standard in pediatric MIS. A systematic review of the literature retrieved from PubMed and published in the last 10 years (2012–2022) was performed. This review underlines that in all children except the smallest infants, where the open procedure has benefits in terms of duration of general anesthetic and there are limitations in the size of instruments, robotic pyeloplasty is becoming the preferred procedure to perform in patients with UPJO. Results for the robotic approach are extremely promising, with shorter operative times than laparoscopy and equal success rates, length of stay and complications. In case of redo pyeloplasty, RALP is easier to perform than other open or MIS procedures. By 2009, robotic surgery became the most used modality to treat all UPJO and continues to grow in popularity. Robot-assisted laparoscopic pyeloplasty in children is safe and effective with excellent outcomes, even in redo pyeloplasty or challenging anatomical cases. Moreover, robotic approach shortens the learning curve for junior surgeons, who can readily achieve levels of expertise comparable to senior practitioners. However, there are still concerns regarding the cost associated with this procedure. Further high-quality prospective observational studies and clinical trials, as well as new technologies specific for the pediatric population, are advisable for RALP to reach the level of gold standard.

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