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Robotic-assisted laparoscopic pyeloplasty (RALP), for ureteropelvic junction obstruction (UPJO), is an alternative to open pyeloplasty in the pediatric population

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Abstract

We aimed to evaluate the safety and efficacy of RALP for UPJO in a heterogeneous pediatric population. The medical records of all patients with UPJO who underwent RALP over the last 6 years and completed at least 6 months of follow-up, were retrospectively reviewed. Data included age, sex, laterality, weight, preoperative and postoperative ultrasound and renal scintigraphy results, operation time, complications, length of hospital stay. We separately examined two groups: low-weight children (< 10 kg) and those who underwent RALP after failed pyeloplasty. One hundred patients with a median age of 18 months (range 2–216) underwent RALP. The median weight was 10 kg (range 4–90). The median operative time, including docking and console time, was 75 min (range 40–183). The median hospital stay was one day (range: 1–3). Ninety-eight percent of the patients showed improvement or stable hydronephrosis on postoperative imaging, with a better drainage curve on dynamic radionuclide scans. In two patients, the hydronephrosis worsened. One patient's ipsilateral UVJ was obstructed, and the other patient's UPJO recurred. The operative time was shorter in the low-weight group (p < 0.001), but the length of hospital stay and success rate were not different. Neither the hospital stay nor the success rate of redo RALP patients differed significantly from a control group of primary RALP patients. Our data show that RALP might be utilized as a universal approach in pediatric patients with UPJO.

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References

  1. Atug F, Woods M, Burgess SV et al (2005) Robotic assisted laparoscopic pyeloplasty in children. J Urol 174(4):1440–1442

    Article  Google Scholar 

  2. Monn MF, Bahler CD, Schneider EB, et al (2013) Trends in robot-assisted laparoscopic pyeloplasty in pediatric patients. J Urol 8(6):1336–1341

  3. Lee RS, Retik AB, Borer JG, Peters CA (2006) Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol 175(2):683–687

    Article  Google Scholar 

  4. Boysen WR, Gundeti MS (2017) Robot-assisted laparoscopic pyeloplasty in the pediatric population: a review of technique, outcomes, complications, and special considerations in infants. Pediatr Surg Int 33(9):925–935

    Article  Google Scholar 

  5. Freilich DA, Penna FJ, Nelson CP 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  Google Scholar 

  6. Esposito C, Masieri L, Blanc T et al (2021) Robot-assisted laparoscopic pyeloplasty (RALP) in children with complex pelvi-ureteric junction obstruction (PUJO): results of a multicenter European report. World J Urol 39(5):1641–1647

    Article  Google Scholar 

  7. Lindgren BW, Hagerty J, Meyer T, Cheng EY (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  Google Scholar 

  8. Hemal AK, Mishra S, Mukharjee S, Suryavanshi M (2008) Robot assisted laparoscopic pyeloplasty in patients of ureteropelvic junction obstruction with previously failed open surgical repair. Internat J Urol 15(8):744–746

    Article  Google Scholar 

  9. Jacobson DL, Shannon R, Johnson E, et al (2019) Robot-assisted laparoscopic reoperative repair for failed pyeloplasty in children: an updated series. J Urol 20(5): 1005–1011

  10. Davis TD, Burns AS, Corbett ST, Peters CA (2016) Reoperative robotic pyeloplasty in children. J Pediatr Urol 12(6):394.e1-394.e7

    Article  CAS  Google Scholar 

  11. Asensio M, Gander R, Royo GF, Lloret JF (2015) pyeloplasty in children: Is robot-assisted laparoscopic reoperative repair feasible? J Pediatr Urol 11(2):6916

  12. Oderda M, Calleris G, Allasia M et al (2017) Robot-assisted laparoscopic pyeloplasty in a pediatric patient with horseshoe kidney: surgical technique and review of the literature. Urologia 84(1):55–60

    Article  Google Scholar 

  13. Nayyar R, Gupta NP, Hemal AK (2010) Robotic management of complicated ureteropelvic junction obstruction. World J Urol 28(5):599–602

    Article  Google Scholar 

  14. Chertin B, Pollack A, Koulikov D et al (2006) Conservative treatment of uretero-pelvic junction obstruction in children with antenatal diagnosis of hydronephrosis: lessons learned after 16 years of follow up. Eur Urol 49(4):734–739

    Article  Google Scholar 

  15. Kafka I, Kocherov S, Jaber J, Chertin B (2019) Pediatric robotic-assisted laparoscopic pyeloplasty (RALP): does weight matter?. Pediatr Surg Int 35(3): 391–396

  16. 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  Google Scholar 

  17. Andreoni C, Gattas N, Araujo M et al (2004) Transmesocolic approach: faster and safe for laparoscopic surgery on the left side. J Urol, suppl 171:318

    Article  Google Scholar 

  18. Cisek LJ, Roth DR, Gonzal ET, Jones EA (2004) Pediatric laparoscopic pyeloplasty. J Endourol, suppl 6:171–177

    Google Scholar 

  19. Sameer M, Aghababian A, Sahar E et al (2021) Primary vs redo robotic pyeloplasty: a comparison of outcomes. J Pediatr Urol 17(4):528.e1-528.e7

    Article  Google Scholar 

  20. Kawal T, Srinivasan AK, Shrivastava D, et al (2018) Pediatric robotic-assisted laparoscopic pyeloplasty: does age matter? J Pediatr Urol 14: 540.e1–540.e6

  21. Dothan D, Raisin G, Jaber J, Kocherov S, Chertin B (2020) Learning curve of robotic-assisted laparoscopic pyeloplasty (RALP) in children: how to reach a level of excellence? J Robot Surg 15(1):93–97

    Article  Google Scholar 

  22. Chertin B, Pollack A, Koulikov D et al (2009) Does renal function remain stable after puberty in children with prenatal hydronephrosis and improved renal function after pyeloplasty? J Urol 182(4S):1845–1848

    Article  Google Scholar 

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Acknowledgements

Kocherov S and Chertin B have equally contributed to this manuscript.

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  1. Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, P.O.B 3235, 91031, Jerusalem, Israel

    S. Cohen, G. Raisin, D. Dothan, J. Jaber, S. Kocherov & B. Chertin

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  1. S. Cohen
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  2. G. Raisin
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  3. D. Dothan
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  4. J. Jaber
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  5. S. Kocherov
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  6. B. Chertin
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Correspondence to S. Cohen.

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Sarit Cohen, David Dothan, Galia Raisin, Jawdat Jaber, Stanislav Kocherov, and Boris Chertin declare that they have no conflict of interest.

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Cohen, S., Raisin, G., Dothan, D. et al. Robotic-assisted laparoscopic pyeloplasty (RALP), for ureteropelvic junction obstruction (UPJO), is an alternative to open pyeloplasty in the pediatric population. J Robotic Surg 16, 1117–1122 (2022). https://doi.org/10.1007/s11701-021-01341-1

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  • DOI: https://doi.org/10.1007/s11701-021-01341-1

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