Abstract
Purpose
To compare outcomes of robotic versus conventional laparoscopic pyeloplasty in children less than 20 kg by weight.
Methods
Nineteen patients undergoing RP and twenty-five LP under 20 kg by weight were compared retrospectively with respect to demographics and operative, postoperative, and follow-up data. For all cases, a lateral transperitoneal approach was used and all anastomoses were stented. Success was defined as the resolution of preoperative symptoms and hydronephrosis postoperatively. If either case is not fulfilled, a renogram was obtained postoperatively. Student’s t test was used for statistical analysis.
Results
Forty-four patients underwent forty-seven pyeloplasties (19 RP and 25 LP), with three patients undergoing bilateral simultaneous laparoscopic procedure with mean age of 2.7 and 2.4 years in RP and LP, respectively. The robotic procedures were superior in terms of shorter mean hospital stay by one and half day on an average. Minimum time taken for RP was 60 min, while for LP it was 90 min. Both procedures were comparable in terms of complication rate, success rate as well as operating time.
Conclusions
This comparative study confirms the feasibility, efficacy, and safety of robotic pyeloplasty in infants and toddlers. The obvious advantage is being shorter hospital stay. Further prospective studies will be needed to show its superiority over LP.
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References
Ferhi K, Rouprêt M, Misraï V, Renard-Penna R, Chartier-Kastler E, Richard F et al (2009) Functional outcomes after pure and robot-assisted laparoscopic pyeloplasty. Actas Urol Esp 33:1103–1107
Baldwin DD, Dunbar JA, Wells N et al (2003) Single-center comparison of laparoscopic pyeloplasty, Acucise endopyelotomy and open pyeloplasty. J Endourol 17:155–160
Eichel L, Ahlering TE, Clayman RV (2004) Role of robotics in laparoscopic urologic surgery. Urol Clin North Am 31:781–792
Meyers RS, Pharm D (2009) Pediatric fluid and electrolyte therapy. J Pediatr Pharmacol Ther 14:204–211
Singh H, Ganpule AP, Malhotra V, Manohar T, Muthu V, Desai MR (2007) Transperitoneal laparoscopic pyeloplasty in pediatric population: single center experience. J Endourol 22:1461–1466
Ganpule AP, Bhattu A, Mishra SK, Desai MR (2012) Ultrasound guided ante-grade access during laparoscopic pyeloplasty in infants less than one year of age: a point of technique. J Minim Access Surg 8:107–110
Nakada StephenY, Thomas HS (2012) Management of upper urinary tract obstruction. In: Kavoussi LR, Partin AW, Novick AC, Peters CA (eds) Campbell–Walsh urology, 10th edn. WB Saunders, Philadelphia
Murthy P, Cohn JA, Gundeti MS (2015) Evaluation of robotic-assisted laparoscopic and open pyeloplasty in children: single-surgeon experience. Ann R Coll Surg Engl 97:109–114
Ekin RG, Celik O, Ilbey YO (2015) An up-to-date overview of minimally invasive treatment methods in ureteropelvic junction obstruction. Cent Eur J Urol 68:245–251
Bird VG, Levellie RJ, Eldefrqu A et al (2011) Comparison of robot assisted versus conventional laparoscopic transperitoneal pyeloplasty for patients with ureteropelvic junction obstruction. Urology 77:730–735
Weise ES, Winfield H (2006) Robotic computer assisted pyeloplasty versus conventional laparoscopic pyeloplasty. J Endourol 20:813–819
Kim S, Canter D, Leone N, Patel R, Casale P (2008) A comparative study between laparoscopic and robotically assisted pyeloplasty in the pediatric population. J Urol 179:357
Riachy E, Cost NG, Defoor WR, Reddy PP, Minevich EA, Noh PH (2013) Pediatric standard and robot-assisted laparoscopic pyeloplasty: a comparative single institution study. J Urol 189:283–287
Chen CC, Ou YC, Yang CK, Chiu KY, Wang SS, Su CK et al (2012) Malfunction of the da Vinci robotic system in urology. Int J Urol 19:736–740
Authors’ contribution
Ganpule A involved in project development, data analysis, and proof reading and wrote the manuscript. Jairath A wrote the manuscript and involved in data collection and analysis. Singh A edited the manuscript and involved in proof reading. Mishra S edited the manuscript and involved in proof reading. Sabnis RB edited the manuscript and involved in proof reading. Desai MR edited the manuscript and involved in proof reading.
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Ganpule, A., Jairath, A., Singh, A. et al. Robotic versus conventional laparoscopic pyeloplasty in children less than 20 kg by weight: single-center experience. World J Urol 33, 1867–1873 (2015). https://doi.org/10.1007/s00345-015-1694-1
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DOI: https://doi.org/10.1007/s00345-015-1694-1