V538 ROBOT-ASSISTED PYELOPLASTY IN A PELVIC KIDNEY

Abstract

You have accessJournal of UrologyPediatrics1 Apr 2012V538 ROBOT-ASSISTED PYELOPLASTY IN A PELVIC KIDNEY Frank J. Penna, Wooju Jeong, and Jack S. Elder Frank J. PennaFrank J. Penna Detroit, MI More articles by this author , Wooju JeongWooju Jeong Detroit, MI More articles by this author , and Jack S. ElderJack S. Elder Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.612AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The role of robot-assisted laparoscopic surgery is rapidly expanding, particularly within the field of pediatric urology. Various techniques have been shown to be feasible and as equipment and techniques improve, more complex reconstructive procedures may be attempted. For the current application, this surgical technique demonstrates the versatility of the robotic surgical system with variations in both patient size and anatomy. We report a robot-assisted procedure for a patient with an ectopically located pelvic kidney. METHODS The patient is an 11-month-old boy who was initially referred for urological evaluation at 2 weeks of age for prenatally detected hydronephrosis in a pelvic kidney. On postnatal work-up, the diagnosis of high-grade ureteropelvic junction obstruction was confirmed. The patient was a candidate for surgical intervention. The procedure began with cystoscopy, bilateral retrograde pyelography and left ureteral stent placement. A left retrograde pyelogram revealed a left-sided hydronephrotic kidney in the pelvis, just right of the midline. Using a tag, the location of the pelvic kidney was identified and labeled on the patient's abdomen to assist in directing proper port placement for the robot-assisted pyeloplasty. RESULTS The patient tolerated the procedure well. There were no complications. The patient was discharged on postoperative day 1 after adequate pain control without intravenous pain medication, return of bowel function, and complete bladder emptying. Follow-up ultrasound was normal. CONCLUSIONS Robot-assisted pyeloplasty is a safe and viable option for patients with an ectopically located pelvic kidney. The use of retrograde pyelography is essential in localizing the pertinent anatomy and for proper port placement and docking. The benefits of this procedure are manifold: patients are discharged sooner, the procedure is safe and efficacious and also offers benefits associated with minimally invasive surgery: less pain, morbidity with a potentially rapid recovery. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e221 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Frank J. Penna Detroit, MI More articles by this author Wooju Jeong Detroit, MI More articles by this author Jack S. Elder Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...