Robot-assisted laparoscopic ureteroureterostomy for proximal ureteral obstructions in children

Smith, Kenneth M.; Shrivastava, D.; Ravish, Indupur R.; Nerli, Rajendra B; Shukla, Aseem R.

doi:10.1016/j.jpurol.2009.03.004

Cited by 39 publications

(12 citation statements)

References 13 publications

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“…Despite this high rate of secondary repairs, a 100% success rate was achieved. Other series have reported high success rates for patients undergoing RAL UU [13,21,22].…”

Section: Unusual Procedures and Pathologiesmentioning

confidence: 89%

Outcomes of robotic‐assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients

et al. 2015

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ObjectiveTo evaluate the long-term outcomes of robotic-assisted laparoscopic (RAL) upper urinary tract (UUT) reconstruction performed at a tertiary referral centre. Materials and MethodsData from 250 consecutive patients undergoing RAL UUT reconstruction, including pyeloplasty with or without stone extraction, ureterolysis, uretero-ureterostomy, ureterocalicostomy, ureteropyelostomy, ureteric reimplantation and buccal mucosa graft ureteroplasty, were collected at a tertiary referral centre between March 2003 and December 2013. The primary outcomes were symptomatic and radiographic improvement of obstruction and complication rate. The mean follow-up was 17.1 months. ResultsRadiographic and symptomatic success rates ranged from 85% to 100% for each procedure, with a 98% radiographic success rate and 97% symptomatic success rate for the entire series. There were a total of 34 complications, none greater than Clavien grade 3. ConclusionRobotic-assisted laparoscopic UUT can be performed with few complications, with durable long-term success, and is a reasonable alternative to the open procedure in experienced robotic surgeons.

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“…Despite this high rate of secondary repairs, a 100% success rate was achieved. Other series have reported high success rates for patients undergoing RAL UU [13,21,22].…”

Section: Unusual Procedures and Pathologiesmentioning

confidence: 89%

Outcomes of robotic‐assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients

et al. 2015

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“…The overall operative time was 53% longer in the robotic group (361±80 minutes vs. 236±58 minutes, p<0.0001). In a study by Smith et al [26], the mean operative time was 12% longer in the robotic group than in the open surgery group. However, the mean length of stay (33 hours vs. 53 hours) and the use of postoperative narcotics were significantly lower in the robotic group.…”

Section: Pediatric Robotic Surgery For Ureteropelvic Junction Obstrucmentioning

confidence: 99%

“…Most surgeons prefer the transperitoneal approach and preoperative retrograde pyelogram and placement of a ureteric stent [26]. Yee et al [12] reported on three children who successfully underwent robotic ureteroureterostomy.…”

Section: Other Pediatric Robotic Surgeriesmentioning

confidence: 99%

Current Status of Robot-Assisted Laparoscopic Surgery in Pediatric Urology

Song

Kim

2014

Korean J Urol

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Laparoscopic procedures for urological diseases in children have been proven to be safe and effective. However, the availability of laparoscopic procedures is still partly limited to experienced, high-volume centers because the procedures are technically demanding. The da Vinci robot system is being used for an increasing variety of reconstructive procedures because of the advantages of this approach, such as motion scaling, greater optical magnification, stereoscopic vision, increased instrument tip dexterity, and tremor filtration. Particularly in pediatric urologic surgery, where the operational field is limited owing to the small abdominal cavity of children, robotic surgical technology has its own strengths. Currently, robots are used to perform most surgeries in children that can be performed laparoscopically. In this review, we aimed to provide a comprehensive overview of the current role of robot-assisted laparoscopic surgery in Pediatric Urology by analyzing the published data in this field. A growing body of evidence supports the view that robotic technology is technically feasible and safe in pediatric urological surgery. Robotic technology provides additional benefits for performing reconstructive urologic surgery, such as in pyeloplasty, ureteral reimplantation, and enterocystoplasty procedures. The main limitations to robotic surgery are its high purchase and maintenance costs and that the cost-effectiveness of this technology remains to be validated.

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“…Only a handful of reports on RA laparoscopic UU (RALUU) have been published. A transperitoneal approach is preferred and most surgeons perform an initial retrograde pyelogram and placement of a ureteric stent [26,27]. Passerotti et al .…”

Section: Surgical Proceduresmentioning

confidence: 99%

Robotic paediatric urology

2012

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What ' s known on the subject? and What does the study add? Robot assisted laparoscopic surgery (RALS) is slowly gaining acceptance in the fi eld of paediatric urology. Accumulating data on safety and effi cacy when performing paediatric robotic urologic procedures has led paediatric urologists to gradually embrace increasingly more complex reconstructive surgeries. Indeed, the unique and delicate movements generated by the robotic system make this technology ideal for children who often require reconstructive procedures.We critically review the current role of RALS in paediatric urology and to analyse the published data, with a special emphasis on the most common applications. We also propose a structured plan to expedite training and the surgical ' learning curve ' .Accepted for publication 9 November 2011 OBJECTIVES • To critically review the current role of robot-assisted laparoscopic surgery (RALS) in paediatric urology and to analyse the published data, with a special emphasis on the most common applications.• One of the greatest benefi ts of RALS has been the ability to truly spread the application of minimally invasive surgery to paediatric surgical patients. The unique attributes of the robotic interface make this technology ideal for children with congenital anomalies, who often require reconstructive procedures.• We also propose a structured plan to expedite training and the surgical ' learning curve ' . PATIENTS AND METHODS • Currently, almost all urological surgical procedures in children have been performed with the assistance of the robotic interface.• The most commonly performed procedures include pyeloplasty, nephrectomy/heminephrectomy and surgery for vesico-ureteric refl ux.• Initial series of bladder augmentation and appendicovesicostomy are available. RESULTS • Initial results with RALS are encouraging and have shown safety similar to open procedures, and outcomes at least equivalent to standard laparoscopy.• Accumulating data have consistently shown that postoperative analgesia requirements and overall hospital stay are decreased.• However, operative durations are signifi cantly longer than their open counterparts, but this is decreasing as experience accumulates. CONCLUSIONS • RALS is already part of paediatric urological surgery.• Larger single-institution case series and comparative studies with the open approach and multi-institutional meta-analyses will help to identify the benefi ts of RALS in paediatric urology.

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Robot-assisted laparoscopic ureteroureterostomy for proximal ureteral obstructions in children

Cited by 39 publications

References 13 publications

Outcomes of robotic‐assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients

Outcomes of robotic‐assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients

Current Status of Robot-Assisted Laparoscopic Surgery in Pediatric Urology

Robotic paediatric urology

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