MP70-10 PEDIATRIC SINGLE PORT ROBOTIC PYELOPLASTY COMPARED TO OPEN AND MULTIPORT COHORTS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP70-10 PEDIATRIC SINGLE PORT ROBOTIC PYELOPLASTY COMPARED TO OPEN AND MULTIPORT COHORTS Jordan Smith, Alexandra Hernandez, Brian Wiseman, Christopher Bayne, and Romano Demarco Jordan SmithJordan Smith More articles by this author , Alexandra HernandezAlexandra Hernandez More articles by this author , Brian WisemanBrian Wiseman More articles by this author , Christopher BayneChristopher Bayne More articles by this author , and Romano DemarcoRomano Demarco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003338.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Da Vinci SP® (single port) surgical system has been used widely in adult urology with comparable peri-operative outcomes compared to multi-port (MP) robotic surgery. However, reports in pediatric urology are limited. We sought to compare operative outcomes in a single pediatric urologist’s open, MP, and SP pyeloplasty experience. METHODS: A retrospective review was performed of all pyeloplasties by a single pediatric urologist in patients <18 y at a tertiary academic center from January 2021 to July 2022. Cases were categorized by approach: open, multiport (MP), or single port (SP). The primary outcomes were entire operative time (OT; defined as cystoscopy to incision close), length of hospital stay (LOS), inpatient opioid use, and post-operative complications (≤30 days). Surgical success (defined as improved nuclear renography drainage or improved renal collecting system dilatation on ultrasonography with resolution of pain) was evaluated as a secondary outcome. RESULTS: During the study period, 6 open, 5 MP, and 11 SP cases were performed. Open cases were performed via flank incision. MP cases were performed via mix of midline port placement and hidden incision endoscopic surgery (HIdES) approach with 3 or 4 trocars. Technique for SP cases evolved during the period. The SP cohort included older children (median 16 y) and larger children (60.1 kg) than open (2.3 mo; 5.7 kg) and MP (4 mo; 6.6 kg) cases. There was no difference in LOS, opioid use, or complications between groups. SP cases were notably longer (median 390 min [376–480 min]) than both open (240 min [240–360 min]) and MP (300 min [200–258 min]) cases. OT for SP cases improved over the last 5 cases (median 388 min) versus the initial 6 (median 405 min). All cases have continued to show a successful repair at a minimum 3 months. Due to sample size, inferential statistics were not able to be performed. CONCLUSIONS: In this single-surgeon experience during early adoption of the SP robot in pediatric urology, SP pyeloplasty cases took substantially longer. This may represent the early learning curve of developing a novel technique. There was no noted difference in other outcomes or complications. Multicenter collaboration of open, MP, and SP data would help account for individual surgeon differences and generate robust samples sizes for inferential statistical analysis. Knowledge of patient-centered opinions regarding the SP incision is warranted to justify SP pyeloplasty over current MP techniques. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1007 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Smith More articles by this author Alexandra Hernandez More articles by this author Brian Wiseman More articles by this author Christopher Bayne More articles by this author Romano Demarco More articles by this author Expand All Advertisement PDF downloadLoading ...