Robotic Ureterocalicostomy in the Pediatric Population

Casale, Pasquale; Mucksavage, Philip; Resnick, Matthew J.; Kim, Steven S.

doi:10.1016/j.juro.2008.08.052

Cited by 59 publications

(35 citation statements)

References 12 publications

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“…The mean operative time was 168 minutes, and the mean hospital stay was 21 hours. [26] There was no evidence of obstruction following the operation in any patient.…”

Section: Outcomementioning

confidence: 77%

“…Ureterocalicostomy Indication: Robotic-assisted ureterocalicostomy (RAUC) is a potential option in patients with UPJO and significant lower pole caliectasis, patients with failed pyeloplasty and a minimal pelvis, or patients with an exaggerated intrarenal pelvis. [26] Surgical technique: A transperitoneal approach is implemented. The colon is reflected, exposing the massively dilated kidney.…”

Section: Outcomementioning

confidence: 99%

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Robotic-assisted laparoscopic surgery in pediatric urology: an update

Kojima¹,

Khurgin²,

Casale³

2012

Turkish Journal of Urology

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Laparoscopic procedures for urological diseases in children, such as nephrectomy, pyeloplasty and orchiopexy, have proven to be safe and effective with outcomes comparable to open procedures. The main drawback has been the relatively steep learning curve for this procedure that is associated with technical difficulties such as suturing and anastomosis. More recently, robotic-assisted laparoscopic surgery (RAS) has gained enormous popularity in adult urology and is increasingly being adopted around the world; however, few pediatric urology series have been reported. RAS has several advantages over conventional laparoscopic surgery, mainly the simplification and precision of exposure and suturing. The robotic arms move in real time with an increased degree of freedom and a magnified, 3-dimensional view. These features render RAS ideal for complex reconstructive surgery in a pediatric urological population. This review discusses the role of RAS in pediatric urology, provides technical aspects of RAS and offers a critical summary of current knowledge on its indications and outcomes. Almost all operations that are classically performed as open or conventional laparoscopic reconstructive surgeries for children with urological anomalies could be replaced by RAS and this procedure may be established as an alternative minimally invasive surgery in the future.Key words: Laparoscopy; minimally invasive surgery; pediatrics; robotics; urinary tract reconstruction; urology. ÖZETÇocuklarda nefrektomi, piyeloplasti ve orşiopeksi gibi ürolojik hastalıklar için laparoskopik prosedürlerin, açık prosedürlerle kıyaslanabilir sonuçlar ile birlikte, güvenli ve etkili olduğu kanıtlanmıştır. Bu prosedür-lerin, sütür atma ve anastamoz gibi teknik zorluklarla ilişkili göreceli dik öğrenme eğrisi olması başlıca dezavantaj olmaktadır. Son zamanlarda, robot yardımlı laparoskopik cerrahi (RAS) erişkin ürolojisinde olağanüstü bir popülerlik kazanmıştır ve bütün dünyada giderek artan bir şekilde kabul görmektedir; buna karşın, bir kaç pediatrik üroloji serisi yayınlanmıştır. RAS konvansiyonel laparoskopik cerrahiye kıyasla bir kaç avantaja sahiptir; bunların başlıcaları pozlama ve sütur atmanın kolaylığı ve hassasiyetidir. Robot kollar artmış bir serbestlik derecesinde ve büyütülmüş 3 boyutlu bir bakış açısıyla gerçek zamanlı olarak hareket etmektedir. Bu özellikler RAS'ı pediatrik ürolojik populasyonda kompleks rekonstrüktif cerrahi için ideal yapmaktadır. Bu derleme pediatrik ürolojide RAS'ın rolünü tartışmakta, RAS'ın teknik yönlerini bildirmekte ve endikasyonları ve sonuçları hakkında güncel bilgilerin eleştirel bir özetini sunmaktadır. Ürolojik anomalisi olan çocuklar için açık veya konvansiyonel laparoskopik rekonstrüktif cerrahi şeklinde klasik olarak yapılan hemen hemen tüm operasyonların yerine RAS yapılabilir ve bu prosedür gelecekte alternatif bir minimal invaziv cerrahi olarak yerleşebilir.

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“…The mean operative time was 168 minutes, and the mean hospital stay was 21 hours. [26] There was no evidence of obstruction following the operation in any patient.…”

Section: Outcomementioning

confidence: 77%

Section: Outcomementioning

confidence: 99%

Robotic-assisted laparoscopic surgery in pediatric urology: an update

Kojima¹,

Khurgin²,

Casale³

2012

Turkish Journal of Urology

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“…Básicamente son: el síndrome de la unión pieloureteral en el que una pieloplastia convencional no puede realizarse, bien sea de primera intención, bien en reintervención 7 ; las complicaciones de la cirugía de la litiasis renal 8 ; el tratamiento de las secuelas renales de la tuberculosis renal 3,9 ; el drenaje de los riñones en herradura 5 ; en el tratamiento de los traumatismos renales, aunque de manera excepcional; el drenaje de los divertículos caliciales inferiores y finalmente en la conservación de un trasplante renal asociado a isquemia ureteropiélica, irreparable por otros procedimientos. Entre las indicaciones primarias para la ureterocalicostomía también se encuentra la hidronefrosis en la edad pediátrica 1 . Determinadas anomalías renales como la ectopia renal, anomalías de fusión y malrotación renal en las que el cáliz inferior puede ser la zona más declive para el drenaje urinario pueden situar a la ureterocalicostomía en mejores condiciones que las de una pieloplastia convencional.…”

Section: Comentariounclassified

“…Actualmente la indicación mayoritaria de esta técnica es la hidronefrosis pediátrica y sus reintervenciones 1 . De hecho, el urólogo medio puede realizar una ureterocalicostomía una o dos veces en toda su vida profesional 2 .…”

Section: Introductionunclassified

La ureterocalicostomía: ¿una cirugía olvidada?

Virseda¹,

Martínez-Ruiz²,

Martínez-Sanchiz³

et al. 2011

Actas Urol Esp

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ResumenIntroducción: la ureterocalicostomía es una técnica quirúrgica que tiene escasas indicaciones y que los urólogos utilizan muy raramente en la actualidad. Material y método: se presenta una paciente con un proceso cicatricial de retracción piélica derecha, que condicionaba uropatía obstructiva sobre los sistemas caliciales superior y medio, y que excluía el sistema calicial inferior. Se llevó a cabo exploración quirúrgica y se efectuó ureterocalicostomía con resultado exitoso. A muy largo plazo la paciente se encuentra curada y con normofuncionalismo renal. Resultados: se presentan los detalles técnicos de dicha cirugía y se revisan, desde una perspectiva actual, las indicaciones de esta técnica y los condicionantes necesarios para obtener un buen resultado. Conclusión: la ureterocalicostomía es una técnica casi olvidada por el urólogo actual, que mantiene vigentes aún algunas indicaciones y premisas. Por ello, debe conocerse y tenerse presente en el arsenal quirúrgico del urólogo dedicado a la cirugía reconstructiva. © 2010 AEU. Publicado por Elsevier España, S.L. Todos los derechos reservados. KEYWORDS Ureterocalicostomy; Anastomosis; Hydronephrosis Ureterocalicostomy: a forgotten surgical technique?Abstract Introduction: ureterocalicostomy is a surgical technique that is rarely indicated and that urologists currently apply very occasionally. Materials and method: a patient with a right pyelical retraction cicatricial process, which resulted in obstructive uropathy of the upper and mid caliceal system, excluding the lower caliceal system is presented. We performed a surgical exploration and ureterocalicostomy with successful result. In the very long term, the patient is cured and has normal kidney functionalism. Results: we present the technical results of the surgery and, from a present-day perspective, we review the indications of this technique and the determining factors required to obtain good results.

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“…Casale et al [18] [15]. Dieser Ansatz scheint eine sinnvolle Option für die Korrektur des vesikoureteralen Refluxes darzustellen [16,17].…”

Section: Roboterassistierte Antirefluxplastikunclassified

Robotische Chirurgie in der Kinderurologie

Zugor

Labanaris

Abdulhak

et al. 2011

Urologe

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The increasing experience obtained through laparoscopy has resulted in the evolution of ablative and reconstructive procedures in the field of paediatric urology. Apart from the established methods of laparoscopic nephrectomy and orchidopexy, nowadays laparoscopic hemi-nephrectomy and pyeloplasty have become standard therapeutic surgical alternatives. Nevertheless, many of these procedures require a high level of experience in laparoscopic preparation and stitching techniques and are thus performed in institutions with greater laparoscopic experience. With the introduction and evolution of the robotic-assisted technique and the availability of smaller instruments and ports (8 and 5 mm), there has been an evolution in the spectrum of complex ablative and reconstructive procedures in the field of paediatric urology as well. Nevertheless, there is a lack of randomised trails and the literature available in this area consists manly of case reports. The purpose of this article is to present the current status and perspectives of robotic-assisted surgery in the field of paediatric urology.

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Robotic Ureterocalicostomy in the Pediatric Population

Abstract: Robotic ureterocalicostomy is a viable and technically feasible treatment option for patients with recurrent ureteropelvic junction obstruction, or patients with difficult intrarenal ureteropelvic junctions.

Cited by 59 publications

References 12 publications

Robotic-assisted laparoscopic surgery in pediatric urology: an update

Robotic-assisted laparoscopic surgery in pediatric urology: an update

La ureterocalicostomía: ¿una cirugía olvidada?

Robotische Chirurgie in der Kinderurologie

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