title: Hidden incision endoscopic surgery (HIdES) trocar placement for pediatric robotic pyeloplasty: comparison to traditional port placement.
abstract: Robotic assisted laparoscopy pyeloplasty (RALP) has been associated with shorter recovery, less pain and improved cosmesis. To minimize visible scars, the hidden incision endoscopic surgery (HIdES) trocar placement has been previously developed. Our aim was to compare outcomes between the HIdES and traditional port placement (TPP) for pediatric RALP. A retrospective study was performed on patients under 15 years of age who underwent RALP at a single institution between August 2011 and November 2013. Patient demographics, intraoperative details, narcotic administration, and complications were reviewed. A total of 49 patients were identified (29 in HIdES, 20 in TPP). There was no difference in median age (p = 0.77) or median height (p = 0.88) between the two groups. Median operative time was 180 min for HIdES and 194 min for TPP (p = 0.27). Eleven patients (11/29, 37.9%) in the HIdES group and fourteen patients (14/20, 70%) in the TPP group received postoperative narcotics (p < 0.05). Median follow-up was 42 months for HIdES and 41 months for TPP (p = 0.96). There were two complications (2/29, 6.9%) with HIdES, and one complication (1/20, 5.0%) with TPP (p = 1.00). The success rates were 96.6% (28/29) for HIdES and 100% (20/20) for TPP (p = 1.00). HIdES trocar placement for pediatric robotic pyeloplasty is a safe and viable alternative to TPP. HIdES is comparable to TPP regarding operative time, narcotic administration, hospital stay, and complication rate, without compromising success.
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA. yaehong@gmail.com.
authors.forename: Yaejee H
authors.initials: YH
authors.lastname: Hong
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA.
authors.forename: W Robert
authors.initials: WR
authors.lastname: DeFoor
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA.
authors.forename: Pramod P
authors.initials: PP
authors.lastname: Reddy
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA.
authors.forename: Marion
authors.initials: M
authors.lastname: Schulte
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA.
authors.forename: Eugene A
authors.initials: EA
authors.lastname: Minevich
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: VanderBrink
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, 45229, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Noh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000517:prevention & control; D004724:Endoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013525:Surgical Instruments
keywords: Pediatrics; Robotic pyeloplasty; Robotic surgical procedures; Urology