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Robot-assisted laparoscopic ureteric reimplantation: extravesical technique
Pankaj P Dangle1, Anup Shah, Mohan S Gundeti
1Department of Surgery, Division of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA.
BJU International
|May 21, 2014
Summary
Robot-assisted extravesical ureteric reimplantation is a feasible surgical technique for children with high-grade vesico-ureteric reflux (VUR). This approach demonstrated acceptable VUR resolution rates and a short hospital stay.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Vesico-ureteric reflux (VUR) is a common condition in children, potentially leading to kidney infections and damage.
- High-grade VUR often requires surgical intervention to prevent long-term renal complications.
Purpose of the Study:
- To present a standardized technique for robot-assisted extravesical ureteric reimplantation.
- To evaluate the efficacy and outcomes of this minimally invasive approach in pediatric patients.
Main Methods:
- A cohort of 29 children with high-grade VUR (grades III-V) underwent the procedure.
- Robot-assisted extravesical ureteric reimplantation was performed between September 2010 and September 2013.
- Postoperative assessments included renal ultrasonography and voiding cysto-urethrogram (VCUG) to evaluate VUR resolution.
Main Results:
- The mean age of patients at surgery was 5.38 years.
- Complete resolution of VUR was observed in 80% of ureters (32/40).
- An additional 87.5% of remaining refluxing ureters showed downgrading of VUR, with a mean hospital stay of 1.8 days.
Conclusions:
- Robot-assisted extravesical ureteric reimplantation is technically feasible in pediatric patients.
- The procedure achieves acceptable rates of VUR resolution.
- This minimally invasive technique offers a viable option for managing high-grade VUR in children.