Summary
Introduction
Robotic partial nephrectomy is a complex minimally invasive procedure that addresses
the intricate anatomy of renal masses while maximizing preservation of renal function.
However, while common in adults, the evolution toward these minimally invasive procedures
for children has been slow due to the anticipated technical difficulties in pediatric-sized
working spaces. We present our technique and our experience with pediatric robotic
partial nephrectomies that were performed with our adult urology colleagues at a large
free-standing children’s hospital.
Methods
The video describes our technique for a robotic right-sided partial nephrectomy in
a 14-month-old male patient. The video highlights several steps of the procedure including
positioning and port placement, tumor resection, and renorrhaphy.
Results
Six pediatric patients underwent robotic partial nephrectomy with our associated adult
urologic surgeons from January 2019 to January 2021. The surgical pathology revealed
both benign as well as malignant diagnoses.
Conclusion
Robotic partial nephrectomy is a feasible minimally invasive procedure in children.
The collaboration with adult minimally invasive urologic surgeons with extensive adult
procedural experience is recommended to avoid potential complications with this technically
challenging procedure in pediatric patients. Pediatric strategies for robotic port
placement are often needed to accommodate the smaller size of pediatric patients as
well as tumor size.
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References
- A literature review of renal surgical anatomy and surgical strategies for partial nephrectomy.Eur Urol. 2015; 68: 980-992https://doi.org/10.1016/j.eururo.2015.04.010
- Robotic partial nephrectomy: expanding utilization, advancing innovation.J Endourol. 2017; 31: 348-354https://doi.org/10.1089/end.2016.0639
- Robot-assisted laparoscopic pyeloplasty in infants using 5-mm instruments.J Pediatr Urol. 2017; 13: 221-222https://doi.org/10.1016/j.jpurol.2016.12.011
- Collaborating with our adult colleagues: a case series of robotic surgery for suspicious and cancerous lesions in children and young adults performed in a free-standing children's hospital.J Pediatr Urol. 2018; 14: 182.e1-182.e8https://doi.org/10.1016/j.jpurol.2018.01.003
- Robotic-assisted laparoscopic management of renal tumors in children: preliminary results.Pediatr Blood Cancer. 2019; 66: 1-7https://doi.org/10.1002/pbc.27867
Article info
Publication history
Published online: July 02, 2022
Accepted:
June 29,
2022
Received in revised form:
June 24,
2022
Received:
December 23,
2021
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
