V7-13 ROBOTIC ASSISTED LAPAROSCOPIC ORCHIOPEXY: PRELIMINARY RESULTS OF AN INITIAL CASE SERIES

Abstract

You have accessJournal of UrologyPediatrics1 Apr 2015V7-13 ROBOTIC ASSISTED LAPAROSCOPIC ORCHIOPEXY: PRELIMINARY RESULTS OF AN INITIAL CASE SERIES Dana Point, John Michael DiBianco, and Osama Al-Omar Dana PointDana Point More articles by this author , John Michael DiBiancoJohn Michael DiBianco More articles by this author , and Osama Al-OmarOsama Al-Omar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1944AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The gold standard in the management of intra-abdominal undescended testicles (UDT) is laparoscopic orchiopexy, either primary or staged Fowler-Stephens (FS) laparoscopic orchiopexy. Outcomes are excellent with a reported success rates around 96% for primary laparoscopic orchiopexy. However a large number of cases, especially older children, will end up with FS orchiopexy, either one or two stages with less favorable outcomes (88% and 78% respectively) and multiple procedures in the case of two stages. We report the results of all robotic assisted laparoscopic orchiopexies performed at our institution. (1,2) METHODS We retrospectively reviewed all robotic orchiopexy between May 2013 and October 2014. Our technique was similar to previously described laparoscopic orchiopexy, either primary, one or two stage FS. RESULTS 11 procedures (6 left, 5 right) on 10 consecutive patients, age 21 months and older underwent robotic orchiopexy in our institution. A total of 5 primary orchiopexies (4 patients), 2 one-stage FS orchiopexies (2 patients) and 4 second-stage FS orchiopexies (4 patients) were performed. Mean age of the patients was 62.2±45.6 months (median 47.5). Mean operative time (cut to close) was 121.6±26.1 minutes. There were no intra-operative or post-operative complications observed, all patient were discharged home on the same day of surgery. The average follow up time was 6.2 weeks (range 1-9) with 100% of testicles viable and palpable low within the scrotum on follow up. CONCLUSIONS We report our preliminary series of Robotic assisted laparoscopic orchiopexy with very promising results. The early positive results, irrespective of the technique used, of our case series indicates that this approach may enable us to perform more intra abdominal UDT in one procedure (Primary vs One stage FS) and possibly improve the outcomes of two-stages FS orchiopexies. We believe that with better visualization of testicular vessels due to HD and 3D technology camera, utilization of Firefly fluorescence angiography with IC Green, increased magnification, and improved instrument articulation will lead to more precise dissection and preservation of testicular vasculature resulting in improved outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e663 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dana Point More articles by this author John Michael DiBianco More articles by this author Osama Al-Omar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...