Robot assisted pyeloplasty in the infant-lessons learned.

Area of Science:

• Pediatric surgery
• Minimally invasive surgery
• Urology

Background:

• Ureteropelvic junction obstruction is a common congenital anomaly in infants.
• Robot-assisted pyeloplasty is an emerging technique for treating this condition.
• Challenges exist in performing minimally invasive surgery in infants due to small abdominal cavities.

Purpose of the Study:

• To present the experience and lessons learned from performing robot-assisted pyeloplasty in infants.
• To evaluate the feasibility and outcomes of this procedure in a pediatric population.

Main Methods:

• Nine infants (3-8 months old) underwent transperitoneal robot-assisted pyeloplasty for ureteropelvic junction obstruction.
• The da Vinci Surgical System was used for the Anderson-Hynes dismembered pyeloplasty.
• Outcomes included operative time, hospital stay, and resolution of obstruction via imaging.

Main Results:

• All nine infants successfully underwent robot-assisted pyeloplasty without conversion to open surgery.
• Mean operative time was 122.8 minutes, with a mean console time of 72.1 minutes.
• Seven infants (78%) showed resolution or improvement of hydronephrosis, with the remaining two having no evidence of obstruction on follow-up imaging.

Conclusions:

• Robot-assisted pyeloplasty is a safe and effective surgical option for infant ureteropelvic junction obstruction.
• The procedure demonstrates successful outcomes in minimally invasive pediatric surgery.
• Further long-term studies are warranted to confirm the sustained benefits of robotic surgery in this population.