Extraperitoneal robotic approach to the uretero-vesical junction in children: Initial experience and a step-by-step video presentation
Year: 2024
Type: article
Study design: Case Report
Abstract: INTRODUCTION & OBJECTIVES: The use of transperitoneal robotic-assisted procedures for ureterovesical junction (UVJ) anomalies in pediatric patients is increasing. However, the extra-peritoneal approach potentially less invasive, remains underexplored with robotic approach in pediatric patients. We present our experience of robot-assisted extra-vesical laparoscopic extra-peritoneal UVJ surgery. MATERIALS & METHODS: Extraperitoneal access was made through a 1,5 cm horizontal incision below the umbilicus. Digital dissection was performed under the rectus fascia to the pubic symphysis. The space was further developed under direct vision with laparoscope. The Da Vinci Xi platform was docked after the placement of 4 robotic 8 mm-trocars and an 8 mm assistant port. RESULTS: We performed extraperitoneal robot-assisted laparoscopic UVJ surgery in 3 patients: - Case 1: 9-year-old boy: left-sided ureterectomy, UV reimplantation (UVR) with psoas hitch for a symptomatic mega-ureter. - Case 2: 13-year-old girl: right-sided VUR on a duplex system treated with an extravesical Lich-Gregoir antireflux plasty. - Case 3: 8-year-old boy: left-sided bladder diverticulectomy with UVR. There is no complication above Clavien 2 and no recurrence of febrile UTI during the follow-up period (from 6 to 17 months). CONCLUSIONS: Extra-peritoneal robotic approach for UVJ surgery further for UVR in pediatric urology seems feasible with good short-term result even for the complex ones.
Source: Journal of Pediatric Urology
Institutions: Centre Hospitalier Universitaire de Nantes, Nantes Université
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,300
OpenAlex ID: W4403016246