“Robotic pyeloplasty in the pediatric population.”
Casale (2009).
Current Opinion in Urology 19(1): 97-101.
Purpose of review: Robotic technology is changing the way surgery is performed. It allows in-situ surgery as well as increased magnification and dexterity for minimally invasive surgery. The development and application of pediatric robotic urology are currently manifesting themselves with a rapid growth. Recent findings: The procedure most performed with the da Vinci system in pediatric urology is pyeloplasty for ureteropelvic junction obstruction. As with laparoscopic pyeloplasty, robotic-assisted pyeloplasty can be performed by a trans or retroperitoneal approach. Suturing is done with a 6-0 monofilament absorbable suture, but one can utilize any 5-0 or 6-0 suture depending on the size of the patient. Currently, it appears that nothing larger than 6-0 for small children and infants is recommended. Robotic-assisted pyeloplasty in children has been demonstrated to be feasible and to have satisfactory results. Summary: Although there are only a few published series on the long-term outcome to date, the short-term data suggest that outcomes are similar to those of open pyeloplasty in children, and it appears to be more than promising. © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
“Robotic pyeloplasty in the pediatric population.”
Casale (2009).
Current Urology Reports 10(1): 55-59.
The procedure most performed with the da Vinci system (Intuitive Surgical, Sunnyvale, CA) in pediatric urology is pyeloplasty for ureteropelvic junction obstruction. As with laparoscopic pyeloplasty, robotic-assisted pyeloplasty (RAP) can be performed by a trans- or retroperitoneal approach. Suturing is done with a 6-0 monofilament absorbable suture, but any 5-0 or 6-0 suture can be used depending on the size of the patient. Currently, it appears that nothing larger than 6-0 is recommended for small children and infants. RAP in children has been demonstrated to be feasible and to have satisfactory results. Although there are only a few published series on the long-term outcome to date, the short-term data suggest that outcomes are similar to those of open pyeloplasty in children, and it appears to be more than promising. © 2009 Springer Science+Business Media, LLC.
“Intraoperative Ultrasound: Application in Pediatric Pyeloplasty.”
Ginger (2009).
Urology 73(2): 377-379.
Objectives: To describe a simple method of using a readily available portable ultrasound device to confirm distal stent placement for antegrade placed stents. Antegrade placement of internal double-J ureteral stents during open or laparoscopic pyeloplasty has become an alternative to retrograde placement but might be less reliable owing to the lack of confirmation of the distal stent position. Methods: The SonoSite S-Nerve ultrasound system was used with a L38 × 10-5 MHz linear array transducer to evaluate the distal curl of the double-J stent within the bladder intraoperatively during da Vinci robotic-assisted pyeloplasty. The patient did not require repositioning or removal of the robotic arms. Results: Visualization of the stent was successful in all patients with an age range of 8 months to 17 years. Conclusions: We present the first published method of using ultrasonography to assess and confirm distal stent placement intraoperatively during antegrade stent placement. This simple method uses off-the-shelf equipment available within most operating rooms. In addition, intraoperative ultrasound confirmation of double-J stent placement allows for the ease of antegrade placement with the distal visual confirmation of the stent position without necessitating fluoroscopy or patient repositioning. © 2009 Elsevier Inc. All rights reserved.
“Pediatric Robotic-Assisted Laparoscopic Diverticulectomy.”
Meeks (2009).
Urology 73(2): 299-301.
Congenital bladder diverticula are rare anomalies of the bladder. Patients present with infection, hematuria, and/or urinary obstruction. We report on the case of a 12-year-old boy who developed gross hematuria and recurrent infection owing to a 12-cm bladder diverticulum. Robotic-assisted laparoscopic diverticulectomy was performed. We describe the first reported robotic-assisted laparoscopic diverticulectomy in a pediatric patient. © 2009 Elsevier Inc. All rights reserved.