Korean J Urol.  2014 Aug;55(8):499-504. 10.4111/kju.2014.55.8.499.

Current Status of Robot-Assisted Laparoscopic Surgery in Pediatric Urology

• Song SH
• Kim KS

• KMID: 1794582
• DOI: http://doi.org/10.4111/kju.2014.55.8.499

Abstract

Laparoscopic procedures for urological diseases in children have been proven to be safe and effective. However, the availability of laparoscopic procedures is still partly limited to experienced, high-volume centers because the procedures are technically demanding. The da Vinci robot system is being used for an increasing variety of reconstructive procedures because of the advantages of this approach, such as motion scaling, greater optical magnification, stereoscopic vision, increased instrument tip dexterity, and tremor filtration. Particularly in pediatric urologic surgery, where the operational field is limited owing to the small abdominal cavity of children, robotic surgical technology has its own strengths. Currently, robots are used to perform most surgeries in children that can be performed laparoscopically. In this review, we aimed to provide a comprehensive overview of the current role of robot-assisted laparoscopic surgery in Pediatric Urology by analyzing the published data in this field. A growing body of evidence supports the view that robotic technology is technically feasible and safe in pediatric urological surgery. Robotic technology provides additional benefits for performing reconstructive urologic surgery, such as in pyeloplasty, ureteral reimplantation, and enterocystoplasty procedures. The main limitations to robotic surgery are its high purchase and maintenance costs and that the cost-effectiveness of this technology remains to be validated.

Keyword

Minimal invasive surgery; Pediatrics; Robotics; Surgery

MeSH Terms

Child
Humans
Laparoscopy/*methods
Robotic Surgical Procedures/*methods
Urologic Diseases/*surgery
Urologic Surgical Procedures/*methods

Figure

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  FIG. 1 Transperitoneoscopic, transmesenteric approach to the renal pelvis can reduce the operative time as demonstrated in this figure. (A) Incision of the mesenteric window over the dilated renal pelvis. (B) Identification of the obstructed ureteropelvic junction. (C) Final view of the operation filed after closure of the mesenteric window following pyeloplasty.

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  FIG. 2 Robotic extravesical detrusorrhaphy technique. Reapproximation of the detrusor creates a long submucosal tunnel (A) and completes the repair (B).

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