This Month in Pediatric Urology

Abstract

You have accessJournal of UrologyThis Month in Pediatric Urology1 Feb 2022This Month in Pediatric Urology Stacy T. Tanaka Stacy T. TanakaStacy T. Tanaka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002330AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Safety and Efficacy of Robot-Assisted Laparoscopic Pyeloplasty Compared to Open Repair in Infants under 1 Year of Age Even as robotic pediatric urological procedures proliferated, open pyeloplasty continued to be standard of care in infants. The robotic assisted laparoscopic approach was ideal for older children, allowing for meticulous anastomotic repair of the ureteropelvic junction while decreasing recovery times and postoperative pain levels. For open infant pyeloplasty, multiple sites had already demonstrated short length of stay and pain management without opioids. Additionally, because of concerns of the decreased instrument working space in small infants, initial published studies on pediatric robotic pyeloplasty were limited to children weighing more than 10 kg. Increasingly, pediatric centers are offering a robot-assisted laparoscopic approach for these smaller infants as well. In this issue of The Journal, Rague et al (page 432) from Chicago compare outcomes from robotic assisted laparoscopic to open pyeloplasty in infants younger than 1 year of age and less than 10 kg.1 In this retrospective study, pyeloplasty was performed by robotic assisted laparoscopic approach in 83 infants and open approach in 121. Infants in the robotic group tended to be older and to weigh more. The authors did not demonstrate a significant difference in length of stay, postoperative radiographic improvement, 30-day complication rate or need for reoperative pyeloplasty. Currently, the robotic procedures required more hospital resources. The robotic procedures had longer operative times, and approximately a third of the robotic procedures had 2 attending co-surgeons. The dissemination of robotics has changed pediatric urology fellowship training much like it has changed general urology residency. The authors report that the robot-assisted laparoscopic approach has been the preferred method for correction of ureteropelvic junction obstruction in infants at their institution since 2017—so much so that no open infant pyeloplasty was performed from January to June 2020. Certainly, the needs of urology learners are ever changing, and pediatric urology educators should be vigilant. This study highlights that trainees may have limited exposure to open infant pyeloplasty in the near future unless it remains an educational priority. Reference 1. : Safety and efficacy of robot-assisted laparoscopic pyeloplasty compared to open repair in infants under 1 year of age. J Urol 2022; 207: 432. Link, Google Scholar © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue 2February 2022Page: 261-261 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stacy T. Tanaka More articles by this author Expand All Advertisement Advertisement Loading ...