Nerve sparing robotic extravesical ureteral reimplantation.
OBJECTIVE
Laparoscopic transvesical ureteral reimplantation with or without robot assisted surgical devices is being developed as an alternative to open surgery. We sought to review our experience with an extravesical robotic technique, to determine whether postoperative voiding dysfunction might be avoided with pelvic plexus visualization and to evaluate the overall feasibility of this approach to ureteral surgery.


METHODS
A total of 41 patients underwent robotic extravesical reimplantation for bilateral vesicoureteral reflux. The patients were divided into groups based on bladder capacity as measured by voiding cystourethrogram. The operation was performed via a transperitoneal approach with robotic assistance using the da Vinci Surgical System.


RESULTS
Operative success rates were 97.6%. There were no complications. There were no episodes of urinary retention documented by bladder scanning.


CONCLUSIONS
Robotic extravesical reimplantation is in its infancy, and visualization of the pelvic plexus appears to be paramount in avoiding postoperative voiding complications. This approach appears to be a feasible and reasonable option for vesicoureteral reflux correction.
Casale
Pasquale
P
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. casale@email.chop.edu
Patel
Rakesh P
RP
Kolon
Thomas F
TF
D002675:Child, Preschool; D003558:Cystoscopy; D006801:Humans; D007001:Hypogastric Plexus / Q000293:injuries; D007223:Infant; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods; D012371:Robotics; D014513:Ureter / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*