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Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy

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Simultaneous bilateral robotic-assisted laparoscopic procedures in children.

Victor Kapoor¹, Jack S Elder^2,3

¹Department of Urology, Vattikuti Urology Institute, Henry Ford Hospital, Department of Urology, Children's Hospital of Michigan, Detroit, MI, USA.

Journal of Robotic Surgery

|November 5, 2015

Summary

Robotic-assisted laparoscopic surgery offers a feasible approach for simultaneous repair of bilateral duplicated urinary systems in children. This single-procedure technique safely corrects complex congenital anomalies with minimal complications and short hospital stays.

Keywords:

Bilateral Duplicated ureter Heminephrectomy Laparoscopy Pediatric Robotic Vesicoureteral reflux

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Area of Science:

Pediatric Urology
Minimally Invasive Surgery
Robotic Surgery

Background:

Bilateral duplicated urinary systems present complex congenital anomalies in children.
Surgical correction often requires multiple procedures, increasing patient burden.
Simultaneous repair strategies are sought to improve efficiency and outcomes.

Purpose of the Study:

To assess the feasibility and safety of simultaneous robotic-assisted laparoscopic (RAL) heminephrectomy with contralateral ureteroureterostomy in children.
To evaluate the outcomes of this combined surgical approach for bilateral renal and ureteral anomalies.

Main Methods:

Three female pediatric patients with bilateral congenital renal/ureteral anomalies underwent concurrent RAL unilateral partial nephrectomy with ureterectomy and contralateral ureteroureterostomy.
A four- or five-port approach was utilized, involving patient repositioning for contralateral side access.
Data collected included operative time, blood loss, length of stay, and postoperative complications.

Main Results:

The mean age at repair was 32.9 months, with a mean operative time of 446 minutes and minimal blood loss (mean 23.3 cc).
Postoperative hospital stay was short (mean 1.7 days), with no significant intraoperative or postoperative complications reported.
Follow-up imaging showed resolution of hydronephrosis in two patients; one had a stable pararenal fluid collection.

Conclusions:

Simultaneous RAL heminephrectomy with contralateral ureteroureterostomy is a safe and feasible approach for children with bilateral duplicated urinary tracts.
This single-stage operative procedure can effectively manage complex congenital anomalies, leading to favorable outcomes and reduced hospital stay.
Robotic assistance facilitates complex reconstructive surgery in pediatric patients with challenging urogenital malformations.