Robotic pyeloplasty in the pediatric population

Robotic technology is changing the way surgery is performed. It allows in-situ surgery as well as increased magnification and dexterity for minimally invasive surgery. The development and application of pediatric robotic urology are currently manifesting themselves with a rapid growth.

The procedure most performed with the da Vinci system in pediatric urology is pyeloplasty for ureteropelvic junction obstruction. As with laparoscopic pyeloplasty, robotic-assisted pyeloplasty can be performed by a trans or retroperitoneal approach. Suturing is done with a 6-0 monofilament absorbable suture, but one can utilize any 5-0 or 6-0 suture depending on the size of the patient. Currently, it appears that nothing larger than 6-0 for small children and infants is recommended. Robotic-assisted pyeloplasty in children has been demonstrated to be feasible and to have satisfactory results.

Although there are only a few published series on the long-term outcome to date, the short-term data suggest that outcomes are similar to those of open pyeloplasty in children, and it appears to be more than promising.