Single-port robotic extraperitoneal pediatric pyeloplasty using low anterior access: Description of technique and initial experience

Jaya Sai Chavali; Brendan Frainey; Roxana Ramos; Ethan Ferguson; Albert Geskin; Nicolas Soputro; Audrey Rhee; Jihad Kaouk

doi:10.1016/j.jpurol.2024.01.009

Single-port robotic extraperitoneal pediatric pyeloplasty using low anterior access: Description of technique and initial experience

J Pediatr Urol. 2024 Jan 11:S1477-5131(24)00011-1. doi: 10.1016/j.jpurol.2024.01.009. Online ahead of print.

Authors

Jaya Sai Chavali¹, Brendan Frainey¹, Roxana Ramos¹, Ethan Ferguson¹, Albert Geskin¹, Nicolas Soputro¹, Audrey Rhee², Jihad Kaouk³

Affiliations

¹ Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
² Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Wake Med Health, Raleigh, NC, USA.
³ Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: kaoukj@ccf.org.

PMID: 38290931
DOI: 10.1016/j.jpurol.2024.01.009

Abstract

Introduction: We aim to report our surgical technique, functional and radiological outcomes of single port (SP) extraperitoneal robotic pediatric pyeloplasty through a low anterior (3 cm) access using a da-Vinci single-port (SP) robotic surgical system in the pediatric population.

Material and methods: We present our initial series of 6 pediatric patients that underwent robotic SP extraperitoneal pyeloplasty between 2022 and 2023. Patient clinicopathologic variables and perioperative outcomes were collected prospectively.

Results: All cases of SP extraperitoneal pyeloplasty were completed without any intraoperative complications or conversion to an open, laparoscopic, or multi-port robotic pyeloplasty. Total operative times including cystoscopy ranged from 178 min to 240 min. All patients tolerated the surgery with minimal postsurgical pain and no narcotic requirement. No intraoperative or immediate postoperative complications were recorded in the cohort. There were no readmissions after discharge at a median follow-up of 12 months (6-18 months) in our series.

Conclusions: Single port extraperitoneal pyeloplasty is a safe and feasible option for upper tract reconstruction in pediatric patients. All patients had complete resolution of symptoms and improvement of hydronephrosis on follow-up imaging.

Keywords: Pediatrics; Pyeloplasty; Robotics; Single port.