Pediatric Urologic Robotic Procedures
Pediatric urologic robotic surgery is emerging as a potentially useful option to gain the benefits of laparoscopic reconstruction, such as decreased perioperative morbidity and improved cosmesis, without having the challenging learning curve of delicate reconstructive laparoscopy in children. Initial experience, particularly with pyeloplasty (described in this chapter) suggests great potential for a wide variety of procedures, including partial nephrectomy, anti-refluxwureteral surgery, continent catheterizable stomas, bladder neck surgery, and retrovesical surgery for persistent Müllerian structures. While the benefits of laparoscopy can be seen in older children, it is difficult to prove this benefit in young children who recover rapidly. This should not be an excuse to restrict application of this potentially valuable technology on the basis of age. Pyeloplasty and ureteral reimplantation has been successfully performed in children as young as 3 months of age in this author’s hands, including as day surgery. New applications should be explored with caution and optimism, followed by a critical and honest appraisal.
KeywordsPartial Nephrectomy Laparoscopic Partial Nephrectomy Intuitive Surgical Needle Driver Polyglactin Suture
Video 16.1 Robotic partial nephrectomy in a child (133 MB)
Video 16.2 Robotic pyeloplasty in children (68.3 MB)
Video 16.3 Extravesical ureteroplasty with robotic assistance (69.0 MB)
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