Preliminary experience of robot-assisted single-port laparoscopic redo pyeloplasty in children

Abstract

Objective

To describe the surgical technique of robot-assisted single-port laparoscopic redo pyeloplasty (RSLRP) in children and to confirm the feasibility of this technique.

Methods

A 12-year-3-month-old boy with recurrent ureteropelvic junction obstruction after robot-assisted laparoscopic surgery underwent RSLRP with da Vinci Xi surgical system. The general clinical characteristics, perioperative variables and follow-up outcomes were summarized.

Results

The child was allowed to drink water up to 2 ​h before surgery. The operation was successfully performed without conversion to open surgery or intraoperative complications. The total operative time was 215 ​min, including 170 ​min of console time, with an estimated blood loss of 10 ​mL. Oral intake was initiated postoperatively upon awakening from anesthesia, starting with clear fluids and advancing to a regular diet as tolerated, with no signs of aspiration. The postoperative complication was gross hematuria (Clavien-Dindo grade Ⅱ), which was improved after conservative treatment. The postoperative hospital stay was 7 days, with total hospitalization duration of 11 days. The ureteral stent was removed 35 days after surgery. Follow-up ultrasound showed improvement of hydronephrosis compared with the preoperative assessment.

Conclusion

The application of the da Vinci Xi surgical system for pediatric RSLRP is safe and feasible. Further studies with larger cohorts and long-term follow-up are warranted to validate the safety and efficacy of RSLRP in the pediatric population.