Robotic assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA)

The area of robotic surgery has steadily changed the field of urology. This minimally invasive approach is proving itself as a practical option, even in the pediatric patient. Robotic surgery allows the surgeon to perform fine suturing and precise dissection under magnified vision, making it ideal for complex reconstructive urinary tract surgery. Mitrofanoff appendicovesicostomy allows for effective emptying of the bladder while maintaining continence in children that cannot otherwise perform urethral catheterizations. Initial reports and series are encouraging, and appear to be comparable to that of open appendicoveiscostomy. In this review, we examine the current literature regarding robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy in children, provide technical recommendations and compare the outcomes with published open series. As more parents seek minimally invasive options for their children and robotic technology continues to develop throughout more centers, robotic surgical applications will expand to even more complex reconstructions.