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Partial nephrectomy for small children: Robot-assisted versus open surgery.

Quentin Ballouhey¹, Aurélien Binet², Pauline Clermidi¹

¹Department of Pediatric Surgery, Limoges University Hospital, Limoges, France.

International Journal of Urology : Official Journal of the Japanese Urological Association

|October 14, 2017

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Robot-assisted heminephrectomy in children with duplex kidneys shows similar outcomes to open surgery. This minimally invasive approach offers shorter hospital stays and less pain, making it a viable alternative for pediatric patients.

Area of Science:

Pediatric Urology
Minimally Invasive Surgery
Nephrology

Background:

Duplex kidneys are a common congenital anomaly.
Heminephrectomy is a surgical procedure to remove half of a kidney.
Robot-assisted surgery is increasingly used in pediatric procedures.

Purpose of the Study:

To compare the outcomes of robot-assisted heminephrectomy with open heminephrectomy for duplex kidneys in children.
To evaluate surgical time, hospital stay, complications, and renal outcomes.

Main Methods:

Retrospective multicentric analysis of pediatric patients undergoing heminephrectomy for duplex kidney from 2007 to 2014.
Comparison of robot-assisted (15 patients) versus open retroperitoneal (13 patients) approaches.
Data collected included demographics, surgical details, and postoperative outcomes; follow-up included clinical review and imaging.

Keywords:

children duplex renal anomaly partial nephrectomy robot-assisted laparoscopic toddler

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Main Results:

Robot-assisted surgery resulted in significantly shorter hospital stays (3.4 days vs. 6.3 days) and lower postoperative pain medication requirements compared to open surgery.
No significant differences were observed in operating time, complication rates, or long-term renal outcomes between the two groups.
All patients, weighing under 15 kg, had preserved renal function post-surgery.

Conclusions:

Robot-assisted heminephrectomy provides comparable renal outcomes to open surgery in small children with duplex kidneys.
While requiring specific technical adjustments and potentially longer setup times, the robotic approach offers benefits in terms of recovery and pain management.