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Mitrofanoff Appendicovesicostomy in Robotic Paediatric Surgery-A Systematic Review
Diana Ronconi Di Giuseppe1,2, Harry Claxton3, Rauand Duhoky1,4,5
1Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK.
Insights
Robotic Mitrofanoff procedures offer a safe and effective option for bladder drainage in children. This review highlights the potential benefits of minimally invasive robotic surgery for this complex procedure.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Effective bladder drainage is essential for children with bladder dysfunction.
- Clean intermittent catheterisation (CIC) can be challenging for impaired individuals.
- The Mitrofanoff procedure creates a channel for continent catheterisation via a stoma.
Purpose of the Study:
- To systematically review the existing literature on robotic Mitrofanoff procedures in pediatric patients.
- To evaluate the safety, efficacy, and outcomes of robotic-assisted Mitrofanoff surgery.
Main Methods:
- A systematic literature review was conducted using PubMed, Cochrane, and Scopus databases.
- Studies were selected based on PRISMA Statement guidelines.
- Included studies were critically appraised using the Newcastle Ottawa Scale.
Main Results:
- Six studies on pediatric robotic Mitrofanoff procedures were included.
- Mean operative time was approximately 499 minutes; median length of stay was 6 days.
- Complication rates were comparable to established benchmarks; robotic approach showed similar outcomes to open surgery.
Conclusions:
- Robotic assistance shows potential advantages for the Mitrofanoff procedure, though still in early stages.
- The robotic approach appears safe and effective for pediatric Mitrofanoff surgery.
- Further high-quality, prospective studies are needed to confirm these findings.
Introduction:
Proper bladder drainage is crucial. Children with bladder dysfunction may require alternative methods like clean intermittent catheterisation (CIC). However, CIC can be challenging for individuals with impairments. The Mitrofanoff procedure provides a solution by connecting the appendix to the bladder and creating a stoma on the skin, allowing for continent catheterisation. Minimally invasive techniques, including robotics, have been adopted recently. The aim of this study is to review the existing literature on robotic Mitrofanoff procedures.
Materials And Methods:
A systematic review on paediatric robotic Mitrofanoff procedures on the PubMed, Cochrane, and Scopus databases was conducted according to the PRISMA Statement. Critical appraisals of the included studies were performed with the Newcastle Ottawa Scale.
Results:
Six studies were included about the robotic Mitrofanoff procedure. Sex was reported in 50% of the studies. Ages were within the twelve-year age limit, as per the inclusion criteria. The mean operative time was 499.3 (±171.1) min. Four of the six studies reported a length of stay with a median of 6 days (±4; range 1.8-23). The incidence of complications was in line with established benchmarks. Only one study compared the Mitrofanoff procedure to open surgery, finding similar outcomes but longer operating times. Port placement and surgical strategy was described.
Conclusions:
Robotics can offer potential advantages for the Mitrofanoff procedure, despite its application still being in its early stages. This study emphasises the potential safety and efficacy of the robotic approach and promotes the need for further prospective high-quality studies.
