Cirugía robótica en urología pediátrica

Abstract

OBJECTIVES: To review the use of robotic surgery in pediatric urology and provide a platform from which discussions regarding this technology can arise. METHODS: The available literature and the experience at the author's institution were reviewed to examine the applications of robotic surgery in pediatric urology. MEDLINE was queried using the following key words: robot, robotic, laparoscopy, surgery, child, and pediatrics. RESULTS: The available literature is comprised mainly of case reports and case series. Two groups have published small analyses comparing robotic assisted laparoscopic pyeloplasty and open pyeloplasty. At our institution, we have utilized the daVinci robotic surgical system to perform the following surgical procedures: orchidopexy of the intraabdominal testis, total and partial nephrectomy, dismembered pyeloplasty, pyelolithotomy, excision of calyceal diverticula, ureteroureterostomy, ureteropyelostomy, intra- and extravesical ureteral reimplantation, megaureter' tapering and reimplantation, adrenelectomy, creation of a Mitrofanoff continent catheterizable channel, and resection of pelvic Mullerian remnants. CONCLUSIONS: Robotic surgery in pediatric urology is an evolving technology that holds promise for application to most urological surgeries. Refinements in equipment will improve the efficiency of these systems. Ultimately, the efficacy and role of robotic surgical systems need to be defined with rigorous prospective studies that provide comparisons to gold standard techniques, be they open surgery or conventional laparoscopy.