Pediatric Robot-Assisted Laparoscopic Varicocelectomy

摘要

PURPOSE: We determined the feasibility and safety of robot-assisted laparoscopic varicocelectomy (RALV) in the pediatric population compared with laparoscopic varicocelectomy (LV). PATIENTS AND METHODS: We identified all patients who underwent RALV since April of 2006. For each case, we selected two age-matched controls who underwent LV and compared the groups in terms of operative times, postoperative complications, and hospital charges. Statistics were determined using the Student t test and the Fisher exact test. RESULTS: Four patients underwent RALV with a mean age of 15.3 years (standard deviation 1.3). All varicoceles were left-sided. Two patients had testicular size discrepancy at presentation (mean 24%). Mean operative times were 112 minutes for RALV vs 73 minutes for LV (P = 0.02). No intraoperative or postoperative complications were experienced in the RALV group. The mean total hospital charge-including facility, equipment, anesthesiology, and recovery room fees, but excluding surgeon's professional fees-was significantly higher for the robot-assisted group ($15,800 vs $8,600, P = 0.0005). CONCLUSION: We report the first RALV in a pediatric patient population. We demonstrate that it is technically feasible with no intraoperative complications. It remains to be seen whether RALV is cost effective over LV.