Low anterior access single port robotic pyeloplasty in a pediatric patient
Introduction and Objective: Single port robotic surgery may be associated with less pain, faster recovery, and improved cosmesis. Herein we demonstrate that the lower anterior access (LAA) approach to single port robotic pyeloplasty is a safe surgical alternative in conjunction with principles of en...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Urology Video Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089725000179 |
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| author | Austin Thompson Kassandra Zaila Ardines Shelby Harper Nicolas Soputro Jihad H. Kaouk John K. Weaver Jessica H. Hannick |
| author_facet | Austin Thompson Kassandra Zaila Ardines Shelby Harper Nicolas Soputro Jihad H. Kaouk John K. Weaver Jessica H. Hannick |
| author_sort | Austin Thompson |
| collection | DOAJ |
| description | Introduction and Objective: Single port robotic surgery may be associated with less pain, faster recovery, and improved cosmesis. Herein we demonstrate that the lower anterior access (LAA) approach to single port robotic pyeloplasty is a safe surgical alternative in conjunction with principles of enhanced recovery after surgery (ERAS) to optimize the management of ureteropelvic junction obstruction (UPJO) in children. Surgical Procedure: Access to the retroperitoneum was gained via a 3.5 cm incision two finger breadths above the superior pubic ramus. A purpose built single port access kit was inserted into the incision after blunt finger dissection. A retroperitoneal robotic dismembered pyeloplasty was performed across a JJ ureteral stent. The patient received an ultrasound-guided transversus abdominis plane block at the conclusion of surgery. Results: Total console time was 95 min. No intraoperative narcotics were given and a total of 3.7 mg oral morphine equivalents was given post-operatively. The patient was discharged the evening of surgery. His left flank pain and hydronephrosis had resolved at follow-up with no complications to date and a single easily concealed scar. Conclusion: The LAA approach to single-port robotic pyeloplasty is a safe alternative that should be offered to pediatric patients with ureteropelvic junction obstruction. This approach may further reduce lengths of stay and the need for opioids while optimizing surgical cosmesis. It may also represent a safer alternative for patients with a history of abdominal surgery. |
| format | Article |
| id | doaj-art-3b8f4f61d0964d88b5fc39febff23b55 |
| institution | Kabale University |
| issn | 2590-0897 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj-art-3b8f4f61d0964d88b5fc39febff23b552025-08-20T03:53:38ZengElsevierUrology Video Journal2590-08972025-06-012610034110.1016/j.urolvj.2025.100341Low anterior access single port robotic pyeloplasty in a pediatric patientAustin Thompson0Kassandra Zaila Ardines1Shelby Harper2Nicolas Soputro3Jihad H. Kaouk4John K. Weaver5Jessica H. Hannick6Case Western Reserve University School of Medicine, Cleveland, OH, USAGlickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USAGlickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USAGlickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USAGlickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USAGlickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Pediatric Urology, Cleveland Clinic Children’s, Cleveland, OH, USAGlickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Pediatric Urology, Cleveland Clinic Children’s, Cleveland, OH, USA; Corresponding author.Introduction and Objective: Single port robotic surgery may be associated with less pain, faster recovery, and improved cosmesis. Herein we demonstrate that the lower anterior access (LAA) approach to single port robotic pyeloplasty is a safe surgical alternative in conjunction with principles of enhanced recovery after surgery (ERAS) to optimize the management of ureteropelvic junction obstruction (UPJO) in children. Surgical Procedure: Access to the retroperitoneum was gained via a 3.5 cm incision two finger breadths above the superior pubic ramus. A purpose built single port access kit was inserted into the incision after blunt finger dissection. A retroperitoneal robotic dismembered pyeloplasty was performed across a JJ ureteral stent. The patient received an ultrasound-guided transversus abdominis plane block at the conclusion of surgery. Results: Total console time was 95 min. No intraoperative narcotics were given and a total of 3.7 mg oral morphine equivalents was given post-operatively. The patient was discharged the evening of surgery. His left flank pain and hydronephrosis had resolved at follow-up with no complications to date and a single easily concealed scar. Conclusion: The LAA approach to single-port robotic pyeloplasty is a safe alternative that should be offered to pediatric patients with ureteropelvic junction obstruction. This approach may further reduce lengths of stay and the need for opioids while optimizing surgical cosmesis. It may also represent a safer alternative for patients with a history of abdominal surgery.http://www.sciencedirect.com/science/article/pii/S2590089725000179PyeloplastyMinimally invasive surgeryRoboticsPediatricEnhanced recovery after surgery |
| spellingShingle | Austin Thompson Kassandra Zaila Ardines Shelby Harper Nicolas Soputro Jihad H. Kaouk John K. Weaver Jessica H. Hannick Low anterior access single port robotic pyeloplasty in a pediatric patient Urology Video Journal Pyeloplasty Minimally invasive surgery Robotics Pediatric Enhanced recovery after surgery |
| title | Low anterior access single port robotic pyeloplasty in a pediatric patient |
| title_full | Low anterior access single port robotic pyeloplasty in a pediatric patient |
| title_fullStr | Low anterior access single port robotic pyeloplasty in a pediatric patient |
| title_full_unstemmed | Low anterior access single port robotic pyeloplasty in a pediatric patient |
| title_short | Low anterior access single port robotic pyeloplasty in a pediatric patient |
| title_sort | low anterior access single port robotic pyeloplasty in a pediatric patient |
| topic | Pyeloplasty Minimally invasive surgery Robotics Pediatric Enhanced recovery after surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2590089725000179 |
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