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Robot-assisted bladder diverticulectomy in the pediatric population
Matthew S Christman1, Pasquale Casale
1Division of Pediatric Urology, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. christmanm@email.chop.edu
Insights
Robot-assisted laparoscopic bladder diverticulectomy (RALBD) is a safe and effective treatment for children with symptomatic congenital bladder diverticula (CBD). This minimally invasive approach successfully resolved symptoms, including diurnal enuresis, in all patients.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Surgical Technology
Background:
- Symptomatic congenital bladder diverticula (CBD) in children often require surgical intervention.
- Traditional open surgery carries potential risks and recovery burdens.
- Evaluating minimally invasive alternatives is crucial for pediatric surgical care.
Purpose of the Study:
- To assess the safety and efficacy of robot-assisted laparoscopic bladder diverticulectomy (RALBD) in children.
- To describe the surgical approach and outcomes of RALBD for CBD.
- To determine if RALBD is a viable alternative to open surgery.
Main Methods:
- Retrospective review of a prospective database of children undergoing robotic bladder diverticulectomy.
- Data collection included presenting symptoms, operative details, and postoperative outcomes.
- Follow-up assessments included voiding cystourethrography (VCUG) and renal/bladder ultrasonography.
Main Results:
- Fourteen pediatric patients underwent RALBD, with a mean age of 7.9 years.
- The procedure was performed safely with no intraoperative or postoperative complications.
- All patients showed successful diverticulectomy on VCUG, and 6/6 with diurnal enuresis experienced resolution of symptoms.
Conclusions:
- Robot-assisted laparoscopic bladder diverticulectomy (RALBD) is a safe and effective treatment for pediatric congenital bladder diverticula (CBD).
- RALBD offers a minimally invasive alternative to open surgery with excellent clinical outcomes.
- The technique successfully addresses associated symptoms like diurnal enuresis.
Background And Purpose:
Surgical intervention is warranted for symptomatic congenital bladder diverticula (CBD) in children. We hypothesized that a robot-assisted approach to bladder diverticulectomy could be performed with safety and with good efficacy. Descriptions of our approach and results with robot-assisted laparoscopic bladder diverticulectomy (RALBD) are presented.
Patients And Methods:
We retrospectively reviewed a prospective database with Institutional Review Board approval. Eligible patients were those who underwent excision of a bladder diverticulum via a robotic approach. Data were collected on presenting symptoms, and intraoperative and postoperative courses. Voiding cystourethrography (VCUG) was performed at 3-month follow-up. Renal and bladder ultrasonography was performed at 3- and 12-month follow-up.
Results:
Fourteen patients were identified. Of the 14 patients, 6 also had a history of diurnal enuresis. Mean patient age was 7.9 years (range 4-13 years). The operation was performed via a transperitoneal approach with robot assistance. The mean operative time (including cystoscopy) was 132.7 minutes (range 113-192 min). The average length of stay was 24.4 hours (range 18-31 hours). There were no intraoperative or postoperative complications in this group. Each patient was followed for at least 1 year. All patients had a normal results of VCUG on follow-up without evidence of a diverticulum. Within 3 months, diurnal enuresis resolved in 6/6 patients.
Conclusions:
RALBD appears to be a safe and effective modality for treatment of patients with CBD. It can serve as an alternative to the open surgical approach.