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Robot-assisted Laparoscopic W-shaped Ileocystoplasty in Children
Amane-Allah Lachkar1, Alexis Arnaud2, Camille Duchesne2
1Department of Pediatric Surgery and Urology, National Reference Centre for Rare Urinary Tract Malformations (CRMR MARVU), Robert-Debré University Hospital, APHP, GHU Nord, Université Paris Cité, Paris, France.
European Urology
|December 18, 2025
Summary
This study introduces robotic-assisted laparoscopic W-shaped ileocystoplasty (RALAWI) in children, a novel technique for bladder augmentation. RALAWI is feasible, even in patients with prior abdominal surgeries, and improves bladder capacity and continence.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robot-assisted bladder augmentation is underutilized in Europe.
- The W-shaped ileal loop configuration is an innovative approach for this procedure.
Purpose of the Study:
- To analyze the preliminary outcomes of robot-assisted laparoscopic W-shaped ileocystoplasty (RALAWI) in pediatric patients.
- To evaluate the feasibility and effectiveness of this novel technique.
Main Methods:
- A prospective bicentric study included 13 pediatric patients undergoing RALAWI between 2020 and 2024.
- Procedures were performed using the DaVinci Xi robot; data analysis was descriptive and comparative.
- Patients had various etiologies including neuropathic bladder, bladder exstrophy, and rhabdomyosarcoma.
Main Results:
- All 13 procedures were completed successfully without conversion, with a median operative time of 670 minutes and length of stay of 12 days.
- Complications included urinary anastomotic leakage, abscess, shunt dysfunction, stoma leakage, bladder stones, and ileocystoplasty perforation.
- Postoperative bladder capacity significantly increased (170 to 350 ml, p < 0.01), and all patients achieved continence.
Conclusions:
- This is the first report of robot-assisted W-shaped ileocystoplasty in children, demonstrating feasibility even in patients with multiple prior abdominal surgeries.
- The technique shows potential benefits for patients with fragile abdominal walls.
- Further refinements are needed to reduce operative time and early postoperative complications.
