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10:35–10:40
S15-3 (VP)
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TIPS FOR SAFETY AND PROFICIENCY FOR RENAL
ROBOT-ASSISTED LAPAROSCOPIC PROCEDURES
IN INFANTS
Nimrod BARASHI , William BOYSEN and Mohan GUNDETI
The University of Chicago, Section of Urology, Chicago, USA
PURPOSE
Robot-assisted laparoscopic (RAL) surgery is being widely embraced by pediatric urologists. The
adoption of this generic system and instrumentation is uniquely challenging in infants, given the
limited working space and little margin of error. In this video, we highlight technical aspects that we
consider critical to maximize safety and proficiency during RAL upper tract surgery in infants.
MATERIAL AND METHODS
Based on our single-surgeon nine-year experience with RAL procedures, we identified some impor-
tant surgical steps that contribute to a safe and efficient procedure.
RESULTS
From a total of 284 cases in nine years, 136 (47.9%) were upper tract procedures and 43 of those
were infants (31.6%). We had 1 early case of port site omental hernia, no complications related to
access, no injuries intra-abdominal organs, and no conversions to open. The median operating time
was 142 minutes (IQR 128-157) and median EBL 5 ml (IQR 5-10). Based on that experience, we
identified these as crucial steps for ensuring a safe and efficient procedure: 1) Patient positioning
and port placement to avoid unintentional injuries and allow for a wide range of movement of the
robotic arms; 2) Docking the robot and placing the instruments while manually controlling the cam-
era; 3) Maximize tissue exposure and reduce damage to adjacent structures; 4) Proper handling
of sutures to guarantee an efficient procedure; 5) Fascial port closure under direct vision to avoid
omental or bowel hernia post-operatively.
CONCLUSIONS
We provide a series of recommendations to optimize safety and proficiency of RAL renal surgery in
infants. As more pediatric urologists adopt the use of this technology and expand its application to
younger patients, these recommendations can help minimize complications.
10:40–10:43
S15-4 (PP)
COMPARISON BETWEEN LAPAROSCOPIC AND OPEN
ANDERSON-HYNES PYELOPLASTY IN INFANTS YOUNGER
THAN 6 MONTHS
Andrea SORIA , Sonia PÉREZ-BERTÓLEZ, Oriol MARTIN
and Luis GARCÍA-APARICIO
Hospital Sant Joan de Deu, Pediatric Surgery department, Esplugues De Llobregat, SPAIN
PURPOSE
The aim of our study is to compare the outcomes of laparoscopic versus open Anderson-Hynes
dismembered pyeloplasty performed in infants younger than 6 months of age at our institution.