Single-Site Laparoscopy and Robotic Surgery in Pediatric Urology
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Purpose of Review
In this review, we summarize research that has evaluated the role of laparoendoscopic single-site (LESS) and robotic surgery in pediatric urology, highlighting new and/or controversial ideas.
The newest research developments over the last several years are studies that address generalizability of these techniques, ideal patient factors, extrapolation to more complex surgeries, and comparative studies to more traditional techniques to define the associated costs and benefits, as well as patient-centered outcomes. Specifically in the field of LESS, addressing the limitations of suboptimal vision, instrument crowding, and loss of triangulation have been a focus. The literature is now replete with new applications for robotic surgery as well as descriptions of the specific technical challenges inherent to pediatrics.
Robotic surgery and LESS are areas of growth in pediatric urology that allow continual innovation and expansion of technology within a surgeon's armamentarium.
KeywordsPediatric urology Laparoendoscopic single-site surgery Robotic surgery LESS
Compliance with Ethical Standards
Conflict of Interest
Diana K. Bowen, Jason P. Van Batavia, and Arun K. Srinivasan each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 6.• Khambati A, Wehbi E, Farhat WA. Laparo-endoscopic single site surgery in pediatrics: Feasibility and surgical outcomes from a preliminary prospective Canadian experience. Can Urol Assoc J = JAssoc Urol Can. 2015;9(1–2):48–52. Primary analysis of pediatric LESS procedures analyzed prospectively. CrossRefGoogle Scholar
- 12.Wang F, Shou T, Zhong H. Is two-port laparoendoscopic single-site surgery (T-LESS) feasible for pediatric hydroceles? Single-center experience with the initial 59 cases. J Pediatr Urol. 2017.Google Scholar
- 16.Van Batavia JP TC, Chu DI, and Srinivasan AK. Laparoscopic inguinal hernia repair by primary peritoneal flap repair: description of technique and initial results in children. Pediatric Urology Fall Congress, Dallas TX. 2016.Google Scholar
- 18.Esposito C, Escolino M, Castagnetti M, Cerulo M, Settimi A, Cortese G, et al. Two decades of experience with laparoscopic varicocele repair in children: standardizing the technique. J Pediatr Urol. 2017.Google Scholar
- 24.Tang ZY, Chen Z, He Y, Chen X, Fang XL, Li DJ, et al. Laparoendoscopic single-site ureteroureterostomy with intraoperative retrograde ureteroscopy-assisted technique for benign proximal and middle ureteral strictures: a single-center experience. J Laparoendosc Adv Surg Tech A. 2014;24(7):493–6.CrossRefPubMedGoogle Scholar
- 27.Aneiros Castro B, Cabezali Barbancho D, Tordable Ojeda C, Carrillo Arroyo I, Redondo Sedano J, Gomez Fraile A. Laparoendoscopic single-site nephrectomy in children: is it a good alternative to conventional laparoscopic approach? J Pediatr Urol 2017.Google Scholar
- 37.Meenakshi-Sundaram B, Furr JR, Malm-Buatsi E, Boklage B, Nguyen E, Frimberger D, et al. Reduction in surgical fog with a warm humidified gas management protocol significantly shortens procedure time in pediatric robot-assisted laparoscopic procedures. J Pediatr Urol. 2017;13(5):489 e1–5.CrossRefGoogle Scholar
- 41.Hong YH, DeFoor WR, Jr, Reddy PP, Schulte M, Minevich EA, VanderBrink BA, et al. Hidden incision endoscopic surgery (HIdES) trocar placement for pediatric robotic pyeloplasty: comparison to traditional port placement. J Robot Surg. 2017.Google Scholar
- 49.Silay MS, Spinoit AF, Undre S, Fiala V, Tandogdu Z, Garmanova T, et al. Global minimally invasive pyeloplasty study in children: results from the Pediatric Urology Expert Group of the European Association of Urology Young Academic Urologists working party. J Pediatr Urol. 2016;12(4):229 e1–7.CrossRefGoogle Scholar
- 57.• Grimsby GM, Dwyer ME, Jacobs MA, Ost MC, Schneck FX, Cannon GM, et al. Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation. J Urol. 2015;193(5 Suppl):1791–5. A multi-institutional review calling into question the outcomes of RALUR, leading to further studies and debate in the literature. CrossRefPubMedGoogle Scholar
- 58.Boysen WR, Ellison JS, Kim C, Koh CJ, Noh P, Whittam B, et al. Multi-institutional review of outcomes and complications of robot-assisted laparoscopic extravesical ureteral reimplantation for treatment of primary vesicoureteral reflux in children. J Urol. 2017;197(6):1555–61.CrossRefPubMedGoogle Scholar