Day Surgery in Children Undergoing Retroperitoneal Robot-assisted Laparoscopic Pyeloplasty: Is It Safe and Feasible?

Re: Aline Broch, Annabel Paye-Jaouen, Beatrice Bruneau, et al. Day Surgery in Children Undergoing Retroperitoneal Robot-assisted Laparoscopic Pyeloplasty: Is It Safe and Feasible? Eur Urol Open Sci 2023;51:55–61

“…Day-case surgery is a popular care pathway because of clear financial, resource, and patient benefits, and progressively more complex procedures are being considered as possible day-case procedures. Ragavan and colleagues [3] demonstrated that in well-selected adult cohorts, day-case robotic surgery is safe and does not result in delayed detection of complications (eg, rectal injury), a finding that is reiterated in the present study [1] . However, valid concerns regarding premature discharge persist and warrant due attention.…”

“…We would like to congratulate Broch and colleagues [1] for adding to the literature and describing their methodology and inclusion criteria for day-case R-RALP; however, we believe that their findings should be interpreted with care, considering the issues we have highlighted here. We agree that day-surgery numbers have increased over the years and can have advantages for patients and health care systems; with adequate protocols, this approach may become the standard of care.…”

“…We read the paper by Broch and colleagues [1] with great interest and commend them for their trial on paediatric retroperitoneal robot-assisted laparoscopic pyeloplasty (R-RALP). The study represents a valuable contribution to the literature, examining the feasibility and safety of R-RALP as a day-case procedure.…”

“…The study represents a valuable contribution to the literature, examining the feasibility and safety of R-RALP as a day-case procedure. It is worth noting that despite scepticism regarding a higher rate of complications because of lack of inpatient monitoring, day robotic surgery is increasingly being considered for both paediatric and adult populations [1] , [2] , [3] . The authors analysed outcomes and complications within the first postoperative month for 32 children undergoing R-RALP in two major Parisian teaching centres, reporting two readmissions after discharge.…”

Reply to Panagiotis Nikolinakos, Ivo Donkov, Joseph M. Norris, and Nikolaos Zavras’s Letter to the Editor re: Aline Broch, Annabel Paye-Jaouen, Beatrice Bruneau, et al. Day Surgery in Children Undergoing Retroperitoneal Robot-assisted Laparoscopic Pyeloplasty: Is It Safe and Feasible? Eur Urol Open Sci 2023;51:55–61

“…We thank Dr. Nikolinakos and colleagues for their letter regarding our prospective study on the feasibility and safety of day surgery (DS) in children undergoing retroperitoneal robot-assisted laparoscopic pyeloplasty (RALP) [1] . We welcome the chance to respond to their comments, and we believe there are interesting points raised that are worthy of discussion and clarification.…”