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Complications in Pediatric Urology Minimally Invasive Surgery

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Minimally Invasive and Robotic-Assisted Surgery in Pediatric Urology

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Abstract

Over the past 25 years, pediatric minimally invasive surgery (MIS) has grown in volume and complexity. Initially, MIS consisted of purely laparoscopic cases. Multiple series have demonstrated low complication rates with pediatric laparoscopy. In the twenty-first century, robotically-assisted laparoscopy grew in popularity and expanded the breadth of MIS cases performed in both adults and in children.

This chapter reviews the outcomes of various pediatric MIS cases. Pyeloplasty continues to be the most commonly performed pediatric MIS procedure. Wheh compared to open surgery, laparoscopic and robotic pyeloplasty have favorable outcomes and low complication rates. These results encompass older pediatric patients and infants. National trends show the total volume of pyeloplasties has remained stable, but the proportion of MIS pyeloplasties has increased over time.

The role of MIS for other pediatric urologic cases is not as strongly defined. This includes ureteral reimplantation, nephrectomy, and bladder reconstructive cases. Although there are multiple series with encouraging results, the volume of cases is still modest in size. We should continue to evaluate results with a discerning eye.

Some providers are skeptical of MIS in children due to concerns of smaller working space, larger port sizes, and potentially increased exposure to anesthesia. However, this chapter summarizes many favorable results of laparoscopic and robotic cases in children. Therefore, MIS continues to be a viable and appealing option for multiple urologic surgeries in children.

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Abbreviations

CHD:

Congenital Heart Disease

LESS:

Laparoendoscopic Single Site Surgery

LP:

Laparoscopic Pyeloplasty

MIS:

Minimally invasive surgery

NSQIP:

National Surgical Quality Improvement Program

OPN:

Open Pyeloplasty

RALMA:

Robotic Assisted Laparoscopic Mitrofanoff Appendicovesicostomy

RALP:

Robotic Assisted Laparoscopic Pyeloplasty

UPJO:

Ureteropelvic Junction Obstruction

UTI:

Urinary Tract Infection

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  1. University of Wisconsin-Madison, Department of Urology, Madison, WI, USA

    Christina Kim

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  1. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Patricio C. Gargollo

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Kim, C. (2020). Complications in Pediatric Urology Minimally Invasive Surgery. In: Gargollo, P.C. (eds) Minimally Invasive and Robotic-Assisted Surgery in Pediatric Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-57219-8_26

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  • DOI: https://doi.org/10.1007/978-3-030-57219-8_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-57218-1

  • Online ISBN: 978-3-030-57219-8

  • eBook Packages: MedicineMedicine (R0)

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