Laparoscopic pyeloplasty in the pediatric patient: hand sewn anastomosis versus robotic assisted anastomosis--is there a difference?

J Urol. 2007 Oct;178(4 Pt 1):1483-6. doi: 10.1016/j.juro.2007.06.012. Epub 2007 Aug 16.

Abstract

Purpose: The most difficult portion of laparoscopic pyeloplasty is the intracorporeal suturing involved in the anastomosis. We identified whether there is a difference in outcomes between a laparoscopic hand sewn anastomosis and a robotic assisted anastomosis.

Materials and methods: We studied 29 patients who underwent pyeloplasty in the last 30 months, including a robotic assisted procedure in 15, a laparoscopic procedure in 12 and an aborted procedure in 2.

Results: Followup was 10 to 122 weeks (average 41). All surgeries except 1 were deemed successful by resolution of hydronephrosis on ultrasound and symptomatic criteria. Intraoperative time for robotic assisted pyeloplasty was 150 to 290 minutes (average +/- SD 223.1 +/- 46.5). Laparoscopic time was 200 to 285 minutes (average 236.5 +/- 24.1).

Conclusions: Robotic assisted and laparoscopic anastomosis produced similar outcomes in pediatric patients who underwent pyeloplasty. Overall operative times did not vary significantly between the 2 procedures. There appeared to be no quantifiable benefits between the 2 procedures.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Anastomosis, Surgical / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hydronephrosis / diagnostic imaging
  • Hydronephrosis / surgery*
  • Kidney Pelvis / surgery*
  • Laparoscopy / methods*
  • Male
  • Outcome and Process Assessment, Health Care
  • Retrospective Studies
  • Robotics*
  • Surgery, Computer-Assisted / methods*
  • Suture Techniques*
  • Ureteral Obstruction / diagnostic imaging
  • Ureteral Obstruction / surgery*
  • Urography