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01-03-2018 | Original Article

Robot-assisted extravesical ureteral reimplantation (revur) for unilateral vesico-ureteral reflux in children: results of a multicentric international survey

Authors: Ciro Esposito, Lorenzo Masieri, Henri Steyaert, Maria Escolino, Raffaele Cerchione, Angela La Manna, Chiara Cini, Thomas S. Lendvay

Published in: World Journal of Urology | Issue 3/2018

Abstract

Purpose

This multicentric international retrospective study aimed to report the outcome of robot-assisted extravesical ureteral reimplantation (REVUR) in patients with unilateral vesico-ureteral reflux (VUR).

Methods

The medical records of 55 patients (35 girls, 20 boys) underwent REVUR in four international centers of pediatric robotic surgery for primary unilateral VUR were retrospectively reviewed. Patients’ average age was 4.9 years. The preoperative grade of reflux was III in 12.7%, IV in 47.3% and V in 40%. Twenty-six patients (47.3%) presented a loss of renal function preoperatively and 10 (18.1%) had a duplex system.

Results

Average robot docking time was 16.2 min (range 5–30). Average total operative time was 92.2 min (range 50–170). No conversions or intra-operative complications were recorded. All patients had a bladder Foley catheter for 24 h post-operatively. Average hospital stay was 2 days (range 1–3). Average follow-up length was 28 months (range 9–60). We recorded three (5.4%) postoperative complications: 1 small urinoma resolved spontaneously (II Clavien) and 2 persistent reflux, only one requiring redo-surgery using endoscopic injection (IIIb Clavien).

Conclusion

REVUR is a safe and effective technique for treatment of primary unilateral VUR. The procedure is easy and fast to perform thanks to the 6° of freedom of robotic arms. The learning curve is short and it is useful to begin the robotics experience with a surgeon expert in robotic surgery as proctor on the 2nd robot console. The high cost and the diameter of instruments remain the main challenges of robotics applications in pediatric urology.

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Title: Robot-assisted extravesical ureteral reimplantation (revur) for unilateral vesico-ureteral reflux in children: results of a multicentric international survey
Authors: Ciro Esposito
Lorenzo Masieri
Henri Steyaert
Maria Escolino
Raffaele Cerchione
Angela La Manna
Chiara Cini
Thomas S. Lendvay
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 3/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2155-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Robot-assisted extravesical ureteral reimplantation (revur) for unilateral vesico-ureteral reflux in children: results of a multicentric international survey

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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