Concurrent management of bilateral ureteropelvic junction obstruction in children using robotic-assisted laparoscopic surgery
Int. braz. j. urol
;
34(2): 198-205, Mar.-Apr. 2008. ilus, tab
Artículo
en Inglés
| LILACS
| ID: lil-484452
ABSTRACT
INTRODUCTION:
Bilateral ureteropelvic junction (UPJ) obstruction occurs infrequently. When surgical management is deemed necessary, staged pyeloplasties traditionally have been recommended to minimize the morbidity associated with performing procedures concurrently. With the advent of robotic-assistance, concurrent surgical management can more readily be performed laparoscopically. In this report, we evaluated the safety and outcome of managing patients with bilateral UPJ obstruction with concurrent robotic-assisted laparoscopic pyeloplasty. MATERIALS ANDMETHODS:
We performed a retrospective review of five patients with bilateral ureteropelvic junction obstruction who underwent concurrent bilateral robotic-assisted pyeloplasties at our institution between October 2003 and April 2007. Technical consideration for patient positioning, robotic set-up, port placement, and the use of a hitch stitches was assessed. The operative time, complications, analgesic needs, length of hospitalization, and overall success of the procedure were evaluated.RESULTS:
Operative time ranged from 235 to 541 minutes (mean = 384). Estimated blood loss was 5-100 cc (mean = 48.0). Length of hospitalization ranged from 1.3 to 3.6 days (mean = 2.4). Ureteral stents were removed 3-8 weeks postoperatively. There were no complications. All kidneys demonstrated decreased hydronephrosis on postoperative ultrasound or improved drainage parameters on diuretic renography or IVP.CONCLUSIONS:
Simultaneous bilateral robotic-assisted laparoscopic pyeloplasties utilizing 4-port access is feasible and safe. It provides an effective method of managing patients with bilateral UPJ obstruction, avoiding the burden and morbidity of performing staged surgeries.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Uréter
/
Obstrucción Ureteral
/
Robótica
/
Laparoscopía
/
Pelvis Renal
Tipo de estudio:
Estudio observacional
/
Factores de riesgo
Límite:
Adolescente
/
Niño
/
Child, preschool
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2008
Tipo del documento:
Artículo
País de afiliación:
Estados Unidos
Institución/País de afiliación:
Harvard Medical School/US
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