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Complications in Pediatric Robotic Urologic Surgery

  • Rodolfo A. Elizondo
  • Gene O. Huang
  • Chester J. Koh
Chapter

Abstract

Robotic-assisted laparoscopic surgery, like other minimally invasive surgical modalities, in children with urologic conditions has proven to be a safe and effective alternative to open surgery and especially for reconstructive pediatric urologic procedures. However, potential complications can occur, especially with the learning curve that exists with all new procedures and techniques. The prevention of complications requires an integrated team approach that includes the surgeon, anesthesiologist, and operating room team members. Avoidance of preoperative complications usually involves adequate patient positioning and padding before surgery that prevents peripheral nerve injury. Intraoperative complications can occur during intra-abdominal access and port placement steps of the procedures with the potential for vessel injury or bowel injury. Postoperative complications have a wide variety of presentations that are dependent on the procedure, such as ureteral reimplantation, pyeloplasty, or complex reconstructive procedures. In general, surgeons early in their robotic surgery learning curve should gradually advance to complex reconstructive cases to help prevent both intra- and postoperative complications.

Keywords

Pediatric urology Complications Robotic surgery Minimally invasive surgery Ureteral reimplantation Pyeloplasty Complex genitourinary reconstruction 

References

  1. 1.
    Van Batavia JP, Casale P. Robotic surgery in pediatric urology. Curr Urol Rep. 2014;15:402.CrossRefPubMedGoogle Scholar
  2. 2.
    Song SH, Kim KS. Current status of robot-assisted laparoscopic surgery in pediatric urology. Korean J Urol. 2014;55:499–504.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Arlen AM, Kirsch AJ. Recent developments in the use of robotic technology in pediatric urology. Expert Rev Med Devices. 2016;13:171–8.CrossRefPubMedGoogle Scholar
  4. 4.
    American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies. Practice advisory for the prevention of perioperative peripheral neuropathies: an updated report by the American Society of Anesthesiologists Task Force on prevention of perioperative peripheral neuropathies. Anesthesiology. 2011;114:741–54.CrossRefGoogle Scholar
  5. 5.
    Dangle PP, Akhavan A, Odeleye M, et al. Ninety-day perioperative complications of pediatric robotic urological surgery: a multi-institutional study. J Pediatr Urol. 2016;12:102.e1–6.CrossRefGoogle Scholar
  6. 6.
    Chai TC, Birder LA. Physiology and pharmacology of the bladder and the urethra. Dallas: Elsevier Health Science; 2016.Google Scholar
  7. 7.
    Azevedo JLMC, Azevedo OC, Miyahira SA, et al. Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review. Surg Endosc. 2009;23:1428–32.CrossRefPubMedGoogle Scholar
  8. 8.
    Passerotti CC, Nguyen HT, Retik AB, et al. Patterns and predictors of laparoscopic complications in pediatric urology: the role of ongoing surgical volume and access techniques. J Urol. 2008;180:681–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Mishra V. Comparative study between harmonic scalpel and LigaSure vessel sealing system in open and laparoscopic surgery. World J Laparosc Surg. 2013;6:1321–4.Google Scholar
  10. 10.
    Obonna GC, Mishra R. Differences between thunderbeat, ligasure and harmonic scalpel energy system in minimally invasive surgery. World J Laparosc Surg. 2014;7:41–4.CrossRefGoogle Scholar
  11. 11.
    Bansal D, Defoor WR, Reddy PP, et al. Complications of robotic surgery in pediatric urology: a single institution experience. Urology. 2013;82:917–20.CrossRefPubMedGoogle Scholar
  12. 12.
    Kaplan JR, Lee Z, Eun DD, et al. Complications of minimally invasive surgery and their management. Curr Urol Rep. 2016;17:47.CrossRefPubMedGoogle Scholar
  13. 13.
    Casale P, Patel RP, Kolon TF. Nerve sparing robotic extravesical ureteral reimplantation. J Urol. 2008;179:1987–9. discussion 1990CrossRefPubMedGoogle Scholar
  14. 14.
    Kasturi S, Sehgal SS, Christman MS, et al. Prospective long-term analysis of nerve-sparing extravesical robotic-assisted laparoscopic ureteral reimplantation. Urology. 2012;79:680–3.CrossRefPubMedGoogle Scholar
  15. 15.
    Dangle PP, Razmaria AA, Towle VL, et al. Is pelvic plexus nerve documentation feasible during robotic assisted laparoscopic ureteral reimplantation with extravesical approach? J Pediatr Urol. 2013;9:442–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Dangle PP, Shah A, Gundeti MS. Robot-assisted laparoscopic ureteric reimplantation: extravesical technique. BJU Int. 2014;114:630–2.CrossRefPubMedGoogle Scholar
  17. 17.
    Gundeti MS, Boysen WR, Shah A. Robot-assisted laparoscopic Extravesical ureteral Reimplantation: technique modifications contribute to optimized outcomes. Eur Urol. 2016;70(5):818–23.CrossRefPubMedGoogle Scholar
  18. 18.
    Akhavan A, Avery D, Lendvay TS. Robot-assisted extravesical ureteral reimplantation: outcomes and conclusions from 78 ureters. J Pediatr Urol. 2014;10:864–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Grimsby GM, Dwyer ME, Jacobs MA, et al. Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation. J Urol. 2015;193:1791–5.CrossRefPubMedGoogle Scholar
  20. 20.
    Schomburg JL, Haberman K, Willihnganz-Lawson KH, et al. Robot-assisted laparoscopic ureteral reimplantation: a single surgeon comparison to open surgery. J Pediatr Urol. 2014;10:875–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Marchini GS, Hong YK, Minnillo BJ, et al. Robotic assisted laparoscopic ureteral reimplantation in children: case matched comparative study with open surgical approach. J Urol. 2011;185:1870–5.CrossRefPubMedGoogle Scholar
  22. 22.
    Silay MS, Baek M, Koh CJ. Robot-assisted laparoscopic extravesical ureteral reimplantation in children: top-down suturing technique without stent placement. J Endourol Endourol Soc. 2015;29:864–6.CrossRefGoogle Scholar
  23. 23.
    Hopf HL, Bahler CD, Sundaram CP. Long-term outcomes of robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction. Urology. 2016;90:106–11.CrossRefPubMedGoogle Scholar
  24. 24.
    Bansal D, Cost NG, DeFoor WR, et al. Infant robotic pyeloplasty: comparison with an open cohort. J Pediatr Urol. 2014;10:380–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Casale P. Robotic pyeloplasty in the pediatric population. Curr Urol Rep. 2009;10:55–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Casella DP, Fox JA, Schneck FX, et al. Cost analysis of pediatric robot-assisted and laparoscopic pyeloplasty. J Urol. 2013;189:1083–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Minnillo BJ, Cruz JAS, Sayao RH, et al. Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol. 2011;185:1455–60.CrossRefPubMedGoogle Scholar
  28. 28.
    Singh P, Dogra PN, Kumar R, et al. Outcomes of robot-assisted laparoscopic pyeloplasty in children: a single center experience. J Endourol Endourol Soc. 2012;26:249–53.CrossRefGoogle Scholar
  29. 29.
    Tasian GE, Casale P. The robotic-assisted laparoscopic pyeloplasty: gateway to advanced reconstruction. Urol Clin North Am. 2015;42:89–97.CrossRefPubMedGoogle Scholar
  30. 30.
    Silva MV, Levy AC, Finkelstein JB, et al. Is peri-operative urethral catheter drainage enough? The case for stentless pediatric robotic pyeloplasty. J Pediatr Urol. 2015;11:175.e1–5.CrossRefGoogle Scholar
  31. 31.
    Famakinwa OJ, Rosen AM, Gundeti MS. Robot-assisted laparoscopic Mitrofanoff appendicovesicostomy technique and outcomes of extravesical and intravesical approaches. Eur Urol. 2013;64:831–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Grimsby GM, Jacobs MA, Gargollo PC. Comparison of complications of robot-assisted laparoscopic and open Appendicovesicostomy in children. J Urol. 2015;194:772–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Gundeti MS, Acharya SS, Zagaja GP, et al. Paediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy (RALIMA): feasibility of and initial experience with the University of Chicago technique. BJU Int. 2011;107:962–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Murthy P, Cohn JA, Selig RB, et al. Robot-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff Appendicovesicostomy in children: updated interim results. Eur Urol. 2015;68:1069–75.CrossRefPubMedGoogle Scholar
  35. 35.
    Wille MA, Zagaja GP, Shalhav AL, et al. Continence outcomes in patients undergoing robotic assisted laparoscopic mitrofanoff appendicovesicostomy. J Urol. 2011;185:1438–43.CrossRefPubMedGoogle Scholar
  36. 36.
    Razmaria AA, Marchetti PE, Prasad SM, et al. Does robot-assisted laparoscopic ileocystoplasty (RALI) reduce peritoneal adhesions compared with open surgery? BJU Int. 2014;113:468–75.CrossRefPubMedGoogle Scholar
  37. 37.
    Schlomer BJ, Copp HL. Cumulative incidence of outcomes and urologic procedures after augmentation cystoplasty. J Pediatr Urol. 2014;10:1043–50.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Gargollo PC. Robotic-assisted bladder neck repair: feasibility and outcomes. Urol Clin North Am. 2015;42:111–20.CrossRefPubMedGoogle Scholar
  39. 39.
    Herz D, Smith J, McLeod D, et al. Robot-assisted laparoscopic management of duplex renal anomaly: comparison of surgical outcomes to traditional pure laparoscopic and open surgery. J Pediatr Urol. 2016;12:44.e1–7.CrossRefGoogle Scholar
  40. 40.
    Malik RD, Pariser JJ, Gundeti MS. Outcomes in pediatric robot-assisted laparoscopic heminephrectomy compared with contemporary open and laparoscopic series. J Endourol Endourol Soc. 2015;29:1346–52.CrossRefGoogle Scholar
  41. 41.
    Wallis MC, Khoury AE, Lorenzo AJ, et al. Outcome analysis of retroperitoneal laparoscopic heminephrectomy in children. J Urol. 2006;175:2277–80. discussion 2280–2282CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Rodolfo A. Elizondo
    • 1
  • Gene O. Huang
    • 1
  • Chester J. Koh
    • 1
  1. 1.Division of Pediatric Urology, Department of Surgery, Texas Children’s Hospital, and Scott Department of UrologyBaylor College of MedicineHoustonUSA

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