Robot-assisted laparoscopic pyeloplasty in infants using 5-mm instruments.
BACKGROUND
Utilization of the robotic approach to pyeloplasty continues to grow in the field of pediatric urology. Adoption in the infant population has perhaps been the slowest because of the limited operative domain and relatively large instruments.


METHODS
In this video, we demonstrate key steps in performing an infant robotic pyeloplasty using the smallest instruments currently available for the da Vinci S and Si systems (Intuitive Surgical, Sunnyvale, California).


RESULTS
At our institution, 20 robot-assisted laparoscopic infant pyeloplasties have been performed using 5-mm instruments. There have been no conversions to an open approach. The patient age ranged from 2 to 9 months old. The average operative time was 2 h and 28 min.


CONCLUSIONS
The treatment success rate was 95% at an average of 8.3 months of follow-up.
Department of Surgery, Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Rice University, Houston, TX, USA.
Henry J
HJ
Paradise
Department of Surgery, Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
Gene O
GO
Huang
Department of Surgery, Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
Rodolfo A
RA
Elizondo Sáenz
Department of Surgery, Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
Minki
M
Baek
Department of Surgery, Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: cxkoh@texaschildrens.org.
Chester J
CJ
Koh
D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D000074643:Nephrotomy / Q000295:instrumentation* / Q000379:methods; D061646:Operative Time; D012189:Retrospective Studies; D018570:Risk Assessment; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D012371:Robotics; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome
Hydronephrosis; Infant; Robotic surgery; Ureteropelvic junction obstruction