Robot-assisted laparoscopic ureteral reimplantation: A single surgeon comparison to open surgery

Schomburg, John; Haberman, Ken; Willihnganz-Lawson, Katie H.; Shukla, Aseem R.

doi:10.1016/j.jpurol.2014.02.013

Cited by 64 publications

(23 citation statements)

References 10 publications

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“…Another possibility is varying VUR resolution definitions or differences in patient backgrounds, such as VUR grade, laterality, complexity, and the presence or absence of bladder bowel dysfunction. However, RALUR's success rates are comparable to those achieved with open or laparoscopic surgery in the hands of an experienced surgeon (Table ) .…”

Section: Distinctive Robotic Surgeries For Pediatric Patientsmentioning

confidence: 78%

Robotic surgery in pediatric urology: Current status

Mizuno

Kojima

Nishio

et al. 2018

Asian J Endoscop Surgery

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Robot‐assisted laparoscopic surgery (RALS) has been increasingly embraced in the fields of adult and pediatric urology, especially in North America and Europe. The advantages of a stable magnified 3‐D view, tremor filtering, and motion scaling allow for precise intracorporeal exposure and suturing. Because most surgeries are performed as reconstructive rather than excision procedures, the robotic platform is particularly feasible for the field of pediatric urology. In this review, we summarize the recent viewpoints on RALS, such as pyeloplasty, ureteral reimplantation, bladder neck reconstruction, bladder neck sling, appendicovesicostomy, bladder diverticulectomy, and treatments for ureterocele or ectopic ureters, and we also critically summarize the current status of the literature. Based on our initial experience, RALS is technically feasible for pediatric patients and may be achieved with comparable surgical outcomes. RALS is also associated with reduced morbidity compared to open surgery to conventional laparoscopic surgery. This evolution will offer an alternative in the treatment pediatric patients, along with improved care and patient quality of life. Further large case series and randomized controlled trials that investigate the robotic platform's technological improvements will help to expand indications of RALS in the field of pediatric urology.

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Section: Distinctive Robotic Surgeries For Pediatric Patientsmentioning

confidence: 78%

Robotic surgery in pediatric urology: Current status

Mizuno

Kojima

Nishio

et al. 2018

Asian J Endoscop Surgery

View full text Add to dashboard Cite

show abstract

“…The reported complications associated with RALUR range from mild to severe [11121314151617181920212223242526272829]. The most common complication is urinary retention, which can be considered a relatively mild complication since it usually does not require an extended hospital stay or additional surgical procedures.…”

Section: Extravesical Approachmentioning

confidence: 99%

“…As a result, minimally invasive surgery options have become increasingly available for many complex reconstructive procedures in pediatric urology. Since first introduced in 2004 [11], robot-assisted laparoscopic ureteral reimplantation (RALUR) has been described as one of these new minimally invasive procedures that have been increasingly adopted and described in several clinical series [1213141516171819202122232425262728293031]. …”

Section: Introductionmentioning

confidence: 99%

Lessons learned over a decade of pediatric robotic ureteral reimplantation

Baek

Koh

2017

Investig Clin Urol

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The da Vinci robotic system has improved surgeon dexterity, ergonomics, and visualization to allow for a minimally invasive option for complex reconstructive procedures in children. Over the past decade, robot-assisted laparoscopic ureteral reimplantation (RALUR) has become a viable minimally invasive surgical option for pediatric vesicoureteral reflux (VUR). However, higher-than-expected complication rates and suboptimal reflux resolution rates at some centers have also been reported. The heterogeneity of surgical outcomes may arise from the inherent and underestimated complexity of the RALUR procedure that may justify its reclassification as a complex reconstructive procedure and especially for robotic surgeons early in their learning curve. Currently, no consensus exists on the role of RALUR for the surgical management of VUR. High success rates and low major complication rates are the expected norm for the current gold standard surgical option of open ureteral reimplantation. Similar to how robot-assisted laparoscopic surgery has gradually replaced open surgery as the most utilized option for prostatectomy in prostate cancer patients, RALUR may become a higher utilized surgical option in children with VUR if the adoption of standardized surgical techniques that have been associated with optimal outcomes can be adopted during the second decade of RALUR. A future standard of RALUR for children with VUR whose parents seek a minimally invasive surgical option can arise if widespread achievement of high success rates and low major complication rates can be obtained, similar to the replacement of open surgery with robot-assisted laparoscopic radical prostectomy as the new strandard for men with prostate cancer.

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“…estimate that it makes up 5.1% of all pediatric ureteral implantations nationally. Although several series show comparable outcomes between the open and robotic methods, it is not as consistently reported as pyeloplasty . Gundeti et al .…”

Section: Program Modelmentioning

confidence: 99%

Setting up a pediatric robotic urology program: A USA institution experience

et al. 2017

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Implementing a robotic urological surgery program requires institutional support, and necessitates a comprehensive, detail-oriented plan that accounts for training, oversight, cost and case volume. Given the prevalence of robotic surgery in adult urology, in many instances it might be feasible to implement a pediatric robotic urology program within the greater context of adult urology. This involves, from an institutional standpoint, proportional distribution of equipment cost and operating room time. However, the pediatric urology team primarily determines goals for volume expansion, operative case selection, resident training and surgical innovation within the specialty. In addition to the clinical model, a robust economic model that includes marketing must be present. This review specifically highlights these factors in relationship to establishing and maintaining a pediatric robotic urology program. In addition, we share our data involving robot use over the program's first nine years

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Robot-assisted laparoscopic ureteral reimplantation: A single surgeon comparison to open surgery

Cited by 64 publications

References 10 publications

Robotic surgery in pediatric urology: Current status

Robotic surgery in pediatric urology: Current status

Lessons learned over a decade of pediatric robotic ureteral reimplantation

Setting up a pediatric robotic urology program: A USA institution experience

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