Pediatric robotic-assisted laparoscopic pyeloplasty (RALP): does weight matter?

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Uretero-pelvic junction obstruction (UPJO) is a common congenital anomaly in children.
• Robotic-assisted laparoscopic pyeloplasty (RALP) is increasingly adopted for UPJO treatment.
• Limited data exists on RALP outcomes in infants and smaller children (<10 kg).

Purpose of the Study:

• To compare the outcomes of RALP in children weighing less than 10 kg with a matched cohort undergoing open pyeloplasty (OP).

Main Methods:

• Prospective RALP cohort compared with a retrospective OP cohort.
• Matched for age, weight, gender, and affected side.
• Outcomes assessed: success rate, complications, hospital stay, pain, and failure rate.

Main Results:

• No significant difference in operative time between RALP (67.8 min) and OP (66.5 min).
• RALP showed no failures, while OP had one failure requiring reintervention.
• Shorter hospital stay for RALP (1 day) vs. OP (2 days).
• Similar postoperative pain scores and low-grade complications in both groups.

Conclusions:

• RALP is a safe and effective option for UPJO in pediatric patients under 10 kg.
• RALP demonstrates comparable success rates and improved hospital stay versus OP.
• Further research may explore long-term outcomes and specific advantages of RALP in this cohort.