Robotic pediatric augmentation cystoplasty: Outcomes over a 15-year experience

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Reconstructive Urology

Background:

• Augmentation cystoplasty (AC) manages neurogenic bladder, with open augmentation ileocystoplasty (OAI) traditionally being the standard.
• Robotic surgery in pediatrics offers potential benefits like shorter hospital stays and reduced pain.
• Limited comparative data exists between robotic-assisted laparoscopic ileocystoplasty (RALI) and OAI.

Purpose of the Study:

• To evaluate the safety and feasibility of RALI.
• To compare RALI outcomes with OAI at a single institution.

Main Methods:

• Retrospective review of 45 pediatric patients undergoing AC between 2008 and 2021.
• Patients were divided into open (OAI) and robotic (RALI) groups.
• Complications were graded using the Clavien-Dindo classification (CDG).

Main Results:

• The robotic group (26 patients) had longer operative times but comparable lengths of stay and return to diet compared to the open group (19 patients).
• The robotic group showed higher rates of upper tract stabilization.
• Similar rates of revision/reversal and CDG I-III complications were observed between groups.

Conclusions:

• RALI is a feasible approach for complex pediatric neurogenic bladder cases.
• Long-term outcomes suggest RALI is a viable alternative to OAI.
• Further experience may reduce operative times, enhancing RALI's suitability.