Introduction of Pediatric Robot-Assisted Pyeloplasty in A Low-Volume Centre

Overview

Journal Clin Pract

Publisher MDPI

Specialty General Medicine

Date 2021 Apr 3

PMID 33804292

Citations 3

Authors

Niklas Pakkasjarvi

Seppo Taskinen

Affiliations

Soon will be listed here.

Abstract

(1) Background: This study investigated the introduction of pediatric robot-assisted pyeloplasty in a low-volume centre with reference to open pyeloplasty with regards to operative times, length of stay (LOS) and outcomes and cost analysis. (2) Methods: Data from 10 consecutive robot-assisted pyeloplasties was compared retrospectively to an age and weight matched cohort of open pyeloplasties operated on during two previous years. Operative times were analyzed in conjunction with LOS, outcomes and cost-analysis from patient records. (3) Results: Operative times remain longer in robot-assisted pyeloplasties (168 (IQR 68) vs. 141 (IQR 51) min), but patients are discharged from the hospital earlier and may return to daily activities earlier. In our hospital, the difference in LOS levels to some degree the cost difference between operations. (4) Conclusions: Robot-assisted pyeloplasty can be safely and economically introduced and maintained in a low-volume centre.

Citing Articles

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Learning Curves in Pediatric Robot-Assisted Pyeloplasty: A Systematic Review.

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References

Menon P, Narasimha Rao K, Bhattacharya A, Mittal B . Outcome analysis of pediatric pyeloplasty in units with less than 20% differential renal function. J Pediatr Urol. 2016; 12(3):171.e1-7. DOI: 10.1016/j.jpurol.2015.12.013. View

Seideman C, Sleeper J, Lotan Y . Cost comparison of robot-assisted and laparoscopic pyeloplasty. J Endourol. 2012; 26(8):1044-8. DOI: 10.1089/end.2012.0026. View

Reinhardt S, Ifaoui I, Thorup J . Robotic surgery start-up with a fellow as the console surgeon. Scand J Urol. 2017; 51(4):335-338. DOI: 10.1080/21681805.2017.1302990. View

Novara G . Editorial comment on: Systematic review and meta-analysis of robotic-assisted versus conventional laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: effect on operative time, length of hospital stay, postoperative.... Eur Urol. 2009; 56(5):857-8. DOI: 10.1016/j.eururo.2009.03.064. View

Varela S, Omling E, Borjesson A, Salo M . Resolution of hydronephrosis after pyeloplasty in children. J Pediatr Urol. 2020; 17(1):102.e1-102.e7. DOI: 10.1016/j.jpurol.2020.10.031. View

Ekin R, Celik O, Ilbey Y . An up-to-date overview of minimally invasive treatment methods in ureteropelvic junction obstruction. Cent European J Urol. 2015; 68(2):245-51. PMC: 4526614. DOI: 10.5173/ceju.2015.543. View

Wagner M, Mayr J, Hacker F . Improvement of renal split function in hydronephrosis with less than 10 % function. Eur J Pediatr Surg. 2008; 18(3):156-9. DOI: 10.1055/s-2008-1038445. View

Gupta D, Chandrasekharam V, Srinivas M, Bajpai M . Percutaneous nephrostomy in children with ureteropelvic junction obstruction and poor renal function. Urology. 2001; 57(3):547-50. DOI: 10.1016/s0090-4295(00)01046-3. View

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

10.

Lone Y, Samujh R, Bhattacharya A, Kanojia R . Outcome of poorly functioning kidneys secondary to PUJO preserved by pyeloplast. J Pediatr Surg. 2016; 52(4):578-581. DOI: 10.1016/j.jpedsurg.2016.11.039. View

11.

Bansal R, Ansari M, Srivastava A, Kapoor R . Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group. J Pediatr Urol. 2011; 8(1):25-8. DOI: 10.1016/j.jpurol.2010.12.012. View

12.

Aziz M, Hossain A, Banu T, Karim M, Islam N, Sultana H . In hydronephrosis less than 10 % kidney function is not an indication for nephrectomy in children. Eur J Pediatr Surg. 2002; 12(5):304-7. DOI: 10.1055/s-2002-35956. View

13.

Kassite I, Braik K, Villemagne T, Lardy H, Binet A . The learning curve of robot-assisted laparoscopic pyeloplasty in children: a multi-outcome approach. J Pediatr Urol. 2018; 14(6):570.e1-570.e10. DOI: 10.1016/j.jpurol.2018.07.019. View

14.

Tasian G, Wiebe D, Casale P . Learning curve of robotic assisted pyeloplasty for pediatric urology fellows. J Urol. 2013; 190(4 Suppl):1622-6. PMC: 3706499. DOI: 10.1016/j.juro.2013.02.009. View

15.

Dowling K, Harmon E, Ortenberg J, Polanco E, EVANS B . Ureteropelvic junction obstruction: the effect of pyeloplasty on renal function. J Urol. 1988; 140(5 Pt 2):1227-30. DOI: 10.1016/s0022-5347(17)42008-8. View

16.

Sorensen M, Delostrinos C, Johnson M, Grady R, Lendvay T . Comparison of the learning curve and outcomes of robotic assisted pediatric pyeloplasty. J Urol. 2011; 185(6 Suppl):2517-22. DOI: 10.1016/j.juro.2011.01.021. View

17.

Gnech M, Berrettini A, Lopes R, Moscardi P, Esposito C, Zucchetta P . Pyeloplasty vs. nephrectomy for ureteropelvic junction obstruction in poorly functioning kidneys (differential renal function <20%): a multicentric study. J Pediatr Urol. 2019; 15(5):553.e1-553.e8. DOI: 10.1016/j.jpurol.2019.05.032. View

18.

Salo M, Sjoberg Altemani T, Anderberg M . Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery. Pediatr Surg Int. 2016; 32(6):599-607. DOI: 10.1007/s00383-016-3869-2. View

19.

Brook N, Delloglio P, Barod R, Collins J, Mottrie A . Comprehensive training in robotic surgery. Curr Opin Urol. 2018; 29(1):1-9. DOI: 10.1097/MOU.0000000000000566. View

20.

Zacchero M, Volpe A, Billia M, Tarabuzzi R, Varvello F, De Angelis P . Transmesenteric approach for left transperitoneal renal surgery: technique and experience. J Laparoendosc Adv Surg Tech A. 2012; 22(2):176-9. DOI: 10.1089/lap.2011.0395. View