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Laparoscopy in the management of pediatric vesicoureteral reflux

Atul A Thakre1, B Sreedhar, C K Yeung

  • 1Division of Pediatric Surgery and Pediatric Urology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China.

Indian Journal of Urology : IJU : Journal of the Urological Society of India
|September 1, 2009
PubMed

Insights

Pediatric vesicoureteral reflux (VUR) management is evolving. Minimally invasive laparoscopic and robot-assisted ureteral reimplantation offer promising alternatives to open surgery for VUR treatment in children.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Surgical Innovation

Background:

  • Vesicoureteral reflux (VUR) affects 0.4-1.8% of children, with 30-50% experiencing it alongside urinary tract infections.
  • Open ureteral reimplantation is the traditional, highly successful treatment for VUR, boasting a 99% success rate.
  • Infantile VUR incidence is notably higher, necessitating effective pediatric treatment strategies.

Purpose of the Study:

  • To review the literature on minimally invasive techniques for pediatric VUR management.
  • To highlight the evolution, operative steps, and outcomes of laparoscopic and robot-assisted ureteral reimplantation.
  • To discuss the current clinical status and share institutional experience with these advanced VUR treatments.

Main Methods:

  • Comprehensive literature review of recent studies on minimally invasive VUR surgery in pediatrics.
  • Analysis of operative techniques, complication rates, and success outcomes for laparoscopic and robot-assisted ureteral reimplantation.
  • Synthesis of current clinical practice and evidence regarding VUR management.

Main Results:

  • Minimally invasive approaches are emerging as viable alternatives to open surgery for pediatric VUR.
  • Laparoscopic and robot-assisted techniques demonstrate promising results in terms of efficacy and safety.
  • The review details the evolution and current status of these advanced surgical methods.

Conclusions:

  • Minimally invasive surgery, including laparoscopic and robot-assisted ureteral reimplantation, represents a significant advancement in pediatric VUR management.
  • These techniques offer a high success rate and low complication profile, comparable to open surgery.
  • Continued research and experience sharing are crucial for optimizing VUR treatment in children.

Keywords:
CO2 pneumovesicumMISda Vinci robotlaparoscopyureteric reimplantationvesicoureteral reflux

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