Introduction of Pediatric Robot-Assisted Pyeloplasty in A Low-Volume Centre

Pakkasjärvi, Niklas; Taskinen, Seppo

doi:10.3390/clinpract11010020

Cited by 5 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2016, Bennett et al [67] found that charges for operative room time and supplies together with anesthesia time dominate the cost difference between RALP and open pyeloplasty, and that efforts to reduce these specific costs should be the focus of future cost-containment measures. A recent work published in 2021 [68] confirmed a similar cost burden of operating theater, instruments, material, and ward convalescence between open and RALP and justified the use of RALP in a low-volume center. The procedure required for double-J stent removal represented an additional cost.…”

Section: Cost Considerationsmentioning

confidence: 87%

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

Esposito¹,

Cerulo²,

Lepore³

et al. 2023

J Robotic Surg

View full text Add to dashboard Cite

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.

show abstract

Section: Cost Considerationsmentioning

confidence: 87%

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

Esposito¹,

Cerulo²,

Lepore³

et al. 2023

J Robotic Surg

View full text Add to dashboard Cite

show abstract

“…While robot-assisted surgery presents many advantages over traditional laparoscopy through increased dexterity and improved and magnified optics, it has been criticized, especially from economic considerations [ 2 ]. Looking at hospital costs, irrespective of robotic acquisition costs, most aspects considered, robot-assisted pyeloplasty is feasible [ 3 ]. Pediatric RALP has also proven safe during the learning process [ 4 ], but the length of the learning process is open for debate with a range of numbers required for proficiency [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Learning Curves in Pediatric Robot-Assisted Pyeloplasty: A Systematic Review

Pakkasjärvi

Krishnan

Ripatti

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

Background: Robot-assisted surgery demands a specific skillset of surgical knowledge, skills, and attitudes from the robotic surgeon to function as part of the robotic team and for maximal utility of the assistive surgical robot. Subsequently, the learning process of robot-assisted surgery entails new modes of learning. We sought to systematically summarize the published data on pediatric robot-assisted pyeloplasty (pRALP) to decipher the learning process by analyzing learning curves. Methods: This review followed the PRISMA guidelines. PubMed, EMBASE, Web of Science, and Scopus databases were systematically searched for ‘learning curve’ AND ‘pediatric pyeloplasty’. All studies presenting outcomes of learning curves (LC) in the context of pRALP in patients < 18 years of age were included. Studies comparing LC in pRALP versus open and/or laparoscopic pyeloplasty were also included; however, those solely focusing on LC in non-robotic approaches were excluded. The methodological quality was assessed using the Newcastle and Ottawa scale. Results: Competency was non-uniformly defined in all fifteen studies addressing learning curves in pRALP. pRALP was considered safe at all stages. Proficiency in pRALP was reached after 18 cases, while competency was estimated to demand 31 operated cases with operative duration as outcome variable. Conclusions: Pediatric RALP is safe during the learning process and ‘learning by doing’ improves efficiency. Competencies with broader implications than time must be defined for future studies.

show abstract

Pediatric Robot-Assisted Laparoscopic Pyeloplasty: Where Are We Now?

Abdulfattah,

Mittal

2024

Curr Urol Rep

View full text Add to dashboard Cite

Introduction of Pediatric Robot-Assisted Pyeloplasty in A Low-Volume Centre

Cited by 5 publications

References 22 publications

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

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

Learning Curves in Pediatric Robot-Assisted Pyeloplasty: A Systematic Review

Pediatric Robot-Assisted Laparoscopic Pyeloplasty: Where Are We Now?

Contact Info

Product

Resources

About