Summary
Introduction
Pediatric surgery began with single-incision flank surgery and has evolved to multi-port
laparoscopic and robotic approaches. Recent technological advances with the single-port
(SP) robot have allowed for transition back to single-incision surgery.
Methods
A 14-year-old paraplegic male with T2 spinal injury presented with neurogenic bladder
and increasing difficulty performing clean intermittent catheterization thus the decision
was made to perform the first SP robotic Mitrofanoff procedure in a pediatric patient.
The SP platform has one 2.5 cm, 4-channel port, a 12 × 10 mm articulating camera,
and 6 mm multi-wristed instruments.
Discussion
The SP robotic Mitrofanoff was completed successfully without issues with space, triangulation
or articulation. There is, however, loss of insufflation with use of laparoscopic
instruments as the seal on the port is difficult to maintain.
The single-port robot has been successfully utilized in seven patients: six underwent
dismembered pyeloplasty and one underwent Mitrofanoff with a median operative time
of 120 min and estimated blood loss of <25 cc. Postoperatively, no patients required
opioid pain medications, and all were discharged in <24 h without complications.
Conlusions
Single-port robotic surgery is feasible in pediatric patients, but patient selection
is key. Future development of the platform is needed to widen application to smaller
patients.
Keywords
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Article Info
Publication History
Published online: March 28, 2021
Accepted:
March 22,
2021
Received in revised form:
March 2,
2021
Received:
November 23,
2020
Identification
Copyright
© 2021 Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company.
