Robot-assisted laparoscopic ipsilateral ureteroureterostomy for ectopic ureters in children: description of technique
David A Leavitt1, Aksharananda Rambachan, Ken Haberman
1Division of Pediatric Urology, University of Minnesota Amplatz Children's Hospital, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
Insights
Robot-assisted laparoscopic ipsilateral ureteroureterostomy (IUU) effectively manages pediatric ureteral duplication with ectopia. This minimally invasive technique shows promising outcomes for children with complex urinary tract anomalies.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Congenital Urologic Anomalies
Background:
- Ureteral duplication with ectopia is a common congenital anomaly in children.
- Ectopic ureters can lead to complications such as urinary tract infections, incontinence, and hydronephrosis.
- Surgical intervention is often necessary to correct these anomalies and prevent long-term sequelae.
Purpose of the Study:
- To present the technique and report outcomes of robot-assisted laparoscopic ipsilateral ureteroureterostomy (IUU).
- To evaluate the safety and efficacy of IUU in managing pediatric ureteral duplication with ectopia.
Main Methods:
- Retrospective review of patients undergoing robot-assisted laparoscopic IUU between December 2010 and October 2011.
- Utilized a three-port intraoperative technique with prior ureteral stent placement.
- Collected data on demographics, diagnosis, operative time, hospital course, complications, and follow-up.
Main Results:
- Five patients (4 female, 1 male) with a mean age of 61 months underwent the procedure.
- All patients had upper pole ectopic ureters; one had an associated ureterocele.
- Mean operative time was 225 minutes, with a mean hospital stay of 1.2 days.
- No intraoperative complications occurred; one patient developed pyelonephritis postoperatively, which resolved.
- All patients experienced symptom resolution, and significant reduction in upper pole hydronephrosis was observed.
Conclusions:
- Robot-assisted laparoscopic IUU is a safe and effective surgical option for pediatric ureteral duplication anomalies.
- The minimally invasive approach facilitates successful management of complex ectopic ureters.
- This technique offers favorable outcomes, including symptom resolution and improved renal function.
Purpose:
We report our experience and present our technique with the robot-assisted laparoscopic ipsilateral ureteroureterostomy (IUU) in the management of ureteral duplication with ectopia in children.
Patients And Methods:
We reviewed our institutional experience for all patients who underwent a robot-assisted laparoscopic IUU at the University of Minnesota Amplatz Children's Hospital between December 2010 and October 2011. An intraoperative, three-port technique was used after a ureteral stent was placed into the ipsilateral lower pole. Demographic information, diagnosis, operative time, hospital course, complications, and follow-up were all evaluated.
Results:
Our series included four female patients and one male patient with a mean age of 61 months (6 to 182 mos). All five had a diagnosis of upper pole ectopic ureters, one of which was associated with an ureterocele. Mean total operative time was 225 minutes (181 to 253 min), and mean hospital stay was 1.2 days (1-2 days). There were no intraoperative complications. In follow-up, at the time of ureteral stent removal, pyelonephritis developed in one patient, but all patients had resolution of their presenting symptoms including urinary tract infections and incontinence. A significant reduction in upper pole hydronephrosis was seen in all patients.
Conclusions:
Our experience indicates that robot-assisted laparoscopic IUU is safe and effective in the management of ureteral duplication anomalies in children.
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