Hidden incision robot-assisted pyeloplasty for children and infants

Cao Hualin; Zhou Huixia; Ma Lifei; Liu Dehong; Zhou Xiaoguang; Tao Tian; Wang Rui; Hao Xuemei; Wang Zhifang; Li Wei

doi:10.19558/j.cnki.10-1020/r.2017.02.003

Abstract：Objective:To evaluate the clinical efficacy of hidden incision robot assisted pyeloplasty (HIRAP) for children and infants with ureteropelvic junction obstruction (UPJO).Methods:Six patients who underwent HIRAP for UPJO were enrolled in our study,the medical records were analyzed retrospectively.In our technique,the operation ports are placed like the traditional laparoscopic surgery.The first robotic working port and camera port are placed below the line of a Pfannenstiel incision.The second working 8 or 5 mm port is placed infraumbilically,and 3 mm assistant port is placed on the 1/3 mid-lower between the second working port and the camera port.The procedure is then carried out as the traditional laparoscopic pyeloplasty.The preoperative,perioperative,and postoperative date were recorded.Postoperative complications were analyzed using the Clavien-Dindo classification.Results:All surgeries were successfully completed without conversion and no intra-operative complication occurred.The mean operative time was 184.5 (120-226) min,the mean estimated blood loss was 9.4(5-15),the abdominal drainage tubes were removed after a mean of 4.3(2-9)days,and the mean postoperative hospital stay was 6.1(4-10) days.Postoperative complications (Clavien Ⅰ-Ⅱ) occurred in 33.3% children,no grade Ⅲ-Ⅳ complication was observed.Ultrasound showed hydronephrosis relieved on the discharge day.All port sites were hidden at the level of a Pfannenstiel incision,there were no visual scar on abdominal if the patient wears a bathing suit (Bikini).Conclusions:HIRAP is a safe and feasible option for the treatment of UPJO in children and infants with less trauma,rapid recovery and good cosmetic results.