Abstract
Robotic surgery in pediatric urology has been gaining popularity since its introduction almost two decades ago. Robotic assisted pyeloplasty is the most common robotic procedure performed in pediatric urology. Advances in robotic technology, instrumentation, patient care and surgical expertise have allowed the correction of ureteropelvic junction (UPJ) obstruction in most patients using this minimally invasive technique. The excellent experience with robotic assisted pyeloplasty has challenged other approaches as a new standard for the treatment of UPJ obstruction. In this review, we will describe the technique as it relates to the different robotic platforms, review the surgical experience and compare its results to other surgical approaches. Also, we will discuss patient and parent satisfaction, cost and financial considerations, along with evaluating the future of robotic surgery in the treatment of UPJ obstruction.
Highlights
Despite its recent beginnings, robotic assisted surgery has been progressing in the treatment of many conditions in pediatric urology
The port position for robotic assisted laparoscopic pyeloplasty will be in straight line for most patients using the DaVinci Xi system (Figure 1)
We retrospectively reviewed our experience with robotic assisted laparoscopic pyeloplasty (RALP) using the DaVinci Xi robotic platform
Summary
Robotic assisted surgery has been progressing in the treatment of many conditions in pediatric urology. The evolution of these devices would bring the Zeus system and the Da Vinci system while continuously increasing their precision and effectivity (1) This new surgical approach was embraced by doctors throughout the US and promoted a statistical increase in use throughout the country (2). The high incidence of UPJO combined with the surgeons’ previous experience with the laparoscopic approach naturally made it a pioneer procedure for robotics in pediatric urology. Robotic assisted laparoscopic pyeloplasty (RALP) had all the advantages of the laparoscopic approach with an ease of use and a much shorter learning curve. This allows some surgeons to transition from open pyeloplasty to a minimally invasive robotic approach without any previous laparoscopic experience. We will discuss patient and parent satisfaction, cost and financial considerations, along with evaluating the future of robotic surgery in the treatment of UPJ obstruction
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