Two decades of robotic pediatric urology: a single-surgeon evolution from adoption to excellence

The establishment of a Center of Excellence in robotic pediatric urology is a deliberate, phased evolution-from individual pioneering procedures to an institution capable of achieving sustained long-term outcomes at par with established standards, training surgeons globally, and driving innovation. This article chronicles a single-surgeon, two-decade journey at the University of Chicago Medicine Comer Children's Hospital across five phases: foundation and initial implementation with critical adult-pediatric partnership; program expansion, care standardization, and infant application; maturation into a Center of Clinical Excellence with durable outcomes; emergence as a training and regional hub through a mini-fellowship, proctorship program, live surgical demonstrations, and multi-institutional collaboration with the Pediatric Urology Robotic Surgery (PURS) group; and a future vision centered on global health equity, telesurgery, and artificial intelligence. This narrative serves as a framework for programs on a similar trajectory.