Abstract
ABSTRACTRobotic surgery has been slow to be fully accepted in the world of pediatric urology largely because of its initial application directed towards adult use and because of the inherent high cost associated with it. However, as previously shown, it has now become the gold standard for adolescent pyeloplasty in The United States. As the adoption of robotic surgery in children has become more widespread, its use has been applied to a broader spectrum of procedures with similar success rates to standard laparoscopy. These procedures include nephrectomy, heminephrectomy, ureteral reimplantation, and ureteroureterostomy. However, it has also shown feasibility and comparable success when compared to open surgery in procedures that were previously deemed too complex to be done by standard laparoscopy. For example, bladder neck reconstruction with Mitrofanoff and Malone procedure as well as bladder augmentation. This review objective is to provide an overview of robotic surgery in pediatric urology, with a focus on the more common cases such as pyeloplasty and reimplantation as well as more complex bladder reconstruction procedures.
Highlights
The benefits of laparoscopic surgery over open surgery are undeniable
Few centers were attempting laparoscopy for complex procedures such as prostatectomy and pyeloplasty and it did not seem that the laparoscopic approach would be favored over the open approach
Prior to the introduction of the robotics, laparoscopic prostatectomy had been performed by a select few surgeons and because of the difficulties mastering the procedure with this technique, it failed to become adopted
Summary
The benefits of laparoscopic surgery over open surgery are undeniable. The decrease in post-operatory pain narcotic use, blood loss and expedited recovery have helped propel the popularity of laparoscopic surgery. There are several primary benefits of robotic surgery over standard laparoscopic. Prior to the introduction of the robotics, laparoscopic prostatectomy had been performed by a select few surgeons and because of the difficulties mastering the procedure with this technique, it failed to become adopted.
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