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Robotic treatment of a type 2 calyceal diverticulum in a child: is suture closure and marsupialisation enough for a good outcome?

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Abstract

Calyceal diverticula in children are rare and 20% eventually become symptomatic. Following the use of laparoscopic or endoscopic treatments, 85% of children report symptomatic relief. However, complete radiological resolution is seen only in three-fourths of the laparoscopic group and a quarter of those treated via endoscopy. Diathermy ablation of the lining and/or prolonged double J stenting has not altered this outcome. The robotic approach is superior to the other two techniques as the leak can be clearly identified and securely suture ligated. We believe that this is the third published report of the successful closure of a calyceal diverticulum in a child using robotic assistance. A ten-year-old boy presented with severe pain in the right flank and a palpable renal swelling. Retrograde injection of contrast outlined a large exophytic calyceal diverticulum (type 2) in the lower pole. Robotic assistance allowed precise suture closure of the neck as well as partial marsupialisation of the diverticulum. The child was discharged within 48 h and remains symptom free 18 months later. Calyceal diverticula are rare but technically challenging entities. We have shown a good outcome with only suture closure of the leak. Diathermy ablation of the lining and prolonged internal stenting were avoided.

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Authors and Affiliations

  1. Department of Pediatric Urology, Apollo Children’s Hospital, 15, Shafee Mohammed Road, Thousand Lights, Chennai, Tamil Nadu, 600028, India

    V. Sripathi & Aparajita Mitra

  2. Department of Pediatric Surgery, Apollo Children’s Hospital, Chennai, India

    Rajiv L. Padankatti

  3. Department of Urology, Apollo Hospitals, Chennai, India

    T. Ganesan

Authors
  1. V. Sripathi
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  2. Aparajita Mitra
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  3. Rajiv L. Padankatti
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  4. T. Ganesan
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Corresponding author

Correspondence to V. Sripathi.

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Conflict of interest

Sripathi V, Mitra A, Padankatti RL and Ganesan T declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study. Written informed consent was obtained from the patient for publication of this Case Report/any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

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Sripathi, V., Mitra, A., Padankatti, R.L. et al. Robotic treatment of a type 2 calyceal diverticulum in a child: is suture closure and marsupialisation enough for a good outcome?. J Robotic Surg 12, 727–730 (2018). https://doi.org/10.1007/s11701-017-0758-1

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  • DOI: https://doi.org/10.1007/s11701-017-0758-1

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