Skip to main content

Advertisement

SpringerLink
Log in

Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Background

A few studies have compared robotic-assisted laparoscopic pyeloplasty (RALP) with open pyeloplasty (OP) in children, but no previous study includes a long-term follow-up of renal function and hydronephrosis in combination with a thorough prospective follow-up of the RALP patients of at least 2 years.

Objective

To analyze perioperative results and long-term outcome of children with obstruction of the ureteropelvic junction, operated on with RALP compared to OP.

Patients and methods

Children ≤15 years operated on with RALP or OP from 2000 through 2013 were reviewed. Patient demographics, perioperative data, postoperative complications, and long-term outcome were evaluated. The outcome was based on pre- and postoperative examination of renal function, hydronephrosis and flank pain.

Results

129 pyeloplasties (84 OP, 39 RALP, 6 reoperations) on 123 patients were included. RALP had significantly longer operative time and shorter postoperative hospital stay, compared to OP. No difference was found in postoperative need of morphine or complication rates. Mean follow-up for RALP with ultrasound was 29 and 25 months with renal scan, compared to 34 and 28 months, respectively, for OP. The success rate for flank pain was 96 and 94 %, for hydronephrosis 93 and 95 %, and renal function 94 and 92 %, for RALP and OP, respectively.

Conclusions

RALP is a safe method, with advantages compared to OP, and with the same success rate. This study supports the use of RALP in children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

AP-measurement:

Anterior–posterior measurement

DMSA:

Dimercaptosuccinic acid

MAG3:

Mercaptoacetyltriglycine

OP:

Open pyeloplasty

RALP:

Robotic-assisted laparoscopic pyeloplasty

UPJO:

Ureteropelvic junction obstruction

US:

Ultrasonography

References

  1. Capello SA et al (2005) Prenatal ultrasound has led to earlier detection and repair of ureteropelvic junction obstruction. J Urol 174(4 Pt 1):1425–1428

    Article  PubMed  Google Scholar 

  2. Morin L et al (1996) Minimal hydronephrosis in the fetus: clinical significance and implications for management. J Urol 155(6):2047–2049

    Article  CAS  PubMed  Google Scholar 

  3. Löfgren P, B.S., Daxberg E-L, Eriksson M, Holmdahl G, Sandin A, Sjövall H, Sjögren P (2014) Pediatric robotically assisted surgery for pyeloplasty and fundoplication. Regional activity-based HTA 2014

  4. Anderson JC, Hynes W (1949) Retrocaval ureter; a case diagnosed pre-operatively and treated successfully by a plastic operation. Br J Urol 21(3):209–214

    Article  CAS  PubMed  Google Scholar 

  5. Mei H et al (2011) Laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children: a systematic review and meta-analysis. J Endourol 25(5):727–736

    Article  PubMed  Google Scholar 

  6. Schuessler WW et al (1993) Laparoscopic dismembered pyeloplasty. J Urol 150(6):1795–1799

    CAS  PubMed  Google Scholar 

  7. Peters CA, Schlussel RN, Retik AB (1995) Pediatric laparoscopic dismembered pyeloplasty. J Urol 153(6):1962–1965

    Article  CAS  PubMed  Google Scholar 

  8. Troxel S et al (2006) Laparoscopy versus dorsal lumbotomy for ureteropelvic junction obstruction repair. J Urol 176(3):1073–1076

    Article  PubMed  Google Scholar 

  9. Tan HL, Roberts JP (1996) Laparoscopic dismembered pyeloplasty in children: preliminary results. Br J Urol 77(6):909–913

    Article  CAS  PubMed  Google Scholar 

  10. Casale P (2009) Robotic pyeloplasty in the pediatric population. Curr Opin Urol 19(1):97–101

    Article  PubMed  Google Scholar 

  11. Palese MA et al (2005) Robot-assisted laparoscopic dismembered pyeloplasty. JSLS 9(3):252–257

    PubMed  PubMed Central  Google Scholar 

  12. Gettman MT et al (2002) A comparison of laparoscopic pyeloplasty performed with the daVinci robotic system versus standard laparoscopic techniques: initial clinical results. Eur Urol 42(5):453–457 (discussion 457-8)

    Article  PubMed  Google Scholar 

  13. Atug F et al (2005) Robotic assisted laparoscopic pyeloplasty in children. J Urol 174(4 Pt 1):1440–1442

    Article  PubMed  Google Scholar 

  14. Casale P (2008) Robotic pediatric urology. Expert Rev Med Devices 5(1):59–64

    Article  PubMed  Google Scholar 

  15. Passerotti C, Peters CA (2006) Pediatric robotic-assisted laparoscopy: a description of the principle procedures. Sci World J 6:2581–2588

    Article  Google Scholar 

  16. Van Batavia JP, Casale P (2014) Robotic surgery in pediatric urology. Curr Urol Rep 15(5):402

    Article  PubMed  Google Scholar 

  17. Lee RS et al (2006) Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol 175(2):683–687 (discussion 687)

    Article  PubMed  Google Scholar 

  18. Yee DS et al (2006) Initial comparison of robotic-assisted laparoscopic versus open pyeloplasty in children. Urology 67(3):599–602

    Article  PubMed  Google Scholar 

  19. Riachy E et al (2013) Pediatric standard and robot-assisted laparoscopic pyeloplasty: a comparative single institution study. J Urol 189(1):283–287

    Article  PubMed  Google Scholar 

  20. Barbosa JA et al (2013) Comparative evaluation of the resolution of hydronephrosis in children who underwent open and robotic-assisted laparoscopic pyeloplasty. J Pediatr Urol 9(2):199–205

    Article  PubMed  Google Scholar 

  21. Kutikov A et al (2006) Robot assisted pyeloplasty in the infant-lessons learned. J Urol 176(5):2237–2239 (discussion 2239-40)

    Article  PubMed  Google Scholar 

  22. Bansal D et al (2014) Infant robotic pyeloplasty: comparison with an open cohort. J Pediatr Urol 10(2):380–385

    Article  CAS  PubMed  Google Scholar 

  23. Shive ML et al (2012) Ureteral fibroepithelial polyp causing urinary obstruction. J Radiol Case Rep 6(7):23–28

    PubMed  PubMed Central  Google Scholar 

  24. Sorensen MD et al (2011) Comparison of the learning curve and outcomes of robotic assisted pediatric pyeloplasty. J Urol 185(6 Suppl):2517–2522

    Article  PubMed  Google Scholar 

  25. Freilich DA et al (2010) Parental satisfaction after open versus robot assisted laparoscopic pyeloplasty: results from modified Glasgow Children’s Benefit Inventory Survey. J Urol 183(2):704–708

    Article  PubMed  Google Scholar 

  26. Behan JW et al (2011) Human capital gains associated with robotic assisted laparoscopic pyeloplasty in children compared to open pyeloplasty. J Urol 186(4 Suppl):1663–1667

    Article  PubMed  Google Scholar 

  27. Olsen LH, Rawashdeh YF, Jorgensen TM (2007) Pediatric robot assisted retroperitoneoscopic pyeloplasty: a 5-year experience. J Urol 178(5):2137–2141 (discussion 2141)

    Article  PubMed  Google Scholar 

  28. Minnillo BJ et al (2011) Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol 185(4):1455–1460

    Article  PubMed  Google Scholar 

  29. Lindgren BW et al (2012) Robot-assisted laparoscopic reoperative repair for failed pyeloplasty in children: a safe and highly effective treatment option. J Urol 188(3):932–937

    Article  PubMed  Google Scholar 

  30. Calisti A et al (2003) Functional outcome after pyeloplasty in children: impact of the cause of obstruction and of the mode of presentation. Eur Urol 43(6):706–710

    Article  CAS  PubMed  Google Scholar 

  31. Rowe CK et al (2012) A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive? J Endourol 26(7):871–877

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Skåne University Hospital, Lasarettsgatan 48, 221 85, Lund, Sweden

    Martin Salö, Tania Sjöberg Altemani & Magnus Anderberg

  2. Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden

    Martin Salö & Magnus Anderberg

Authors
  1. Martin Salö
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tania Sjöberg Altemani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Magnus Anderberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Salö.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Salö, M., Sjöberg Altemani, T. & Anderberg, M. Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery. Pediatr Surg Int 32, 599–607 (2016). https://doi.org/10.1007/s00383-016-3869-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-016-3869-2

Keywords

Search

Navigation