Robot-assisted laparoscopic orchiopexy: A comparative analysis with laparoscopic orchiopexy

Area of Science:

• Urology
• Pediatric Surgery
• Minimally Invasive Surgery

Background:

• Undescended testes (cryptorchidism) are common, with nonpalpable testes posing a significant clinical challenge.
• Laparoscopic orchiopexy is the established gold standard for treating nonpalpable testes.
• Robot-assisted surgery is emerging in urology, prompting comparisons with traditional laparoscopic techniques.

Purpose of the Study:

• To retrospectively compare the success rates, operative times, costs, and complications of robot-assisted laparoscopic orchiopexy (RALO) versus traditional laparoscopic orchiopexy (TLO).
• To evaluate the contemporary outcomes of these two surgical approaches for nonpalpable testes.

Main Methods:

• A retrospective review of patients undergoing laparoscopic orchiopexy (CPT code 54692) between April 2017 and January 2022.
• Exclusion criteria included bilateral procedures, major concomitant surgery, and follow-up less than 6 months.
• Data analyzed included patient demographics, operative notes, success rates, operative time, hospital charges, and complications.

Main Results:

• 16 patients in the TLO group and 17 in the RALO group met inclusion criteria, with all patients achieving a palpable testicle post-surgery.
• Median operative time was significantly longer for RALO (101 minutes) compared to TLO (71 minutes) (p>0.0001).
• Median hospital charges were higher for RALO ($46,455) than TLO ($38,813) (p=0.0069), with one wound infection in the TLO group and none in the RALO group.

Conclusions:

• Robot-assisted laparoscopic orchiopexy demonstrates safety and efficacy in treating nonpalpable testes.
• Currently, RALO is associated with increased operative time and resource utilization compared to TLO.
• Further research may explore cost-effectiveness and long-term outcomes to guide clinical decision-making.