Investig Clin Urol.
2021 Sep;62(5):592-599. 10.4111/icu.20200569.
Comparison of intraoperative and short-term postoperative outcomes between robot-assisted laparoscopic multi-port pyeloplasty using the da Vinci Si system and single-port pyeloplasty using the da Vinci SP system in children
- Affiliations
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- 1Department of Urology, Yonsei University College of Medicine, Seoul, Korea
- 2Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- 3Department of Pediatric Urology, Severance Children’s Hospital, Yonsei University Health System, Seoul, Korea
- KMID: 2519537
- DOI: http://doi.org/10.4111/icu.20200569
Abstract
- Purpose
We compared the intraoperative and postoperative outcomes of single-port robot-assisted laparoscopic pyeloplasty (SRALP) using the da Vinci SP® system and conventional multi-port robot-assisted laparoscopic pyeloplasty (M-RALP) in pediatric patients.
Materials and Methods
Multi-port and single-port pyeloplasty have been performed in pediatric patients in our institution since October 2015 and February 2019, respectively. We conducted an entire cohort comparison. Considering the learning curve of MRALP, we defined the last 15 cases of M-RALP as a subgroup of M-RALP and compared this subgroup with the entire cohort of SRALP patients.
Results
Thirty-one patients who underwent multi-port pyeloplasty and 15 patients who underwent single-port pyeloplasty were enrolled in this study. Age, height, body weight, laterality, surgical indication, and ipsilateral differential renal function were statistically similar in the M-RALP and S-RALP groups. The median operative time (3.0 h vs. 2.4 h; p=0.01) and the median console time (2.2 h vs. 1.5 h; p<0.001) were longer in the M-RALP group than in the S-RALP group. There was no significant difference in operative time or console time between the M-RALP subgroup and the S-RALP group. There were no significant differences in the length of hospitalization, pain score, morphine-equivalent use of analgesics, or postoperative differential renal function in all comparisons.
Conclusions
This study confirmed that pyeloplasty using the da Vinci® SP system can be started by robotic surgeons who can overcome the learning curve. Robot-assisted laparoscopic single-port pyeloplasty is feasible in noninfant pediatric patients.
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