Robotic-assisted laparoscopic bladder augmentation in the pediatric patient.
BACKGROUND
Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient.


METHODS
The patient was a 6 year old (18.5 kg) boy with a neurogenic bladder secondary to lumbar myelomeningocele. Urodynamics revealed a small capacity and poorly compliant bladder and he was incontinent between frequent catheterizations. A robotic augmentation cystoplasty was performed.


RESULTS
At one-month postoperatively, a cystogram revealed no urine leak, and the suprapubic tube was removed. The patient resumed CIC every 3 h during the day and once overnight until postoperative urodynamic studies confirmed safe dynamics, after which the CIC interval was lengthened.


CONCLUSIONS
Robotic bladder augmentation is safe and feasible in a select pediatric population. The entire procedure including preparation of the bowel segment can be completed intracorporeally, even in smaller children.
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA.
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Wiestma
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA.
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Estrada
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA. Electronic address: patricia.cho@childrens.harvard.edu.
P S
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Cho
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA.
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Hollis
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA.
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Yu
D002648:Child; D006801:Humans; D010535:Laparoscopy; D008297:Male; D065287:Robotic Surgical Procedures; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods
Bladder augmentation; Neurogenic bladder; Robotic surgery; Spina bifida