168 / 330
168
28
TH
CONGRESS OF THE ESPU
MATERIAL AND METHODS
The records of 65 patients who underwent RP with ureteral stent placement between October
2012 and March 2016 were retrospectively analysed for demographics, surgical details and com-
plications. Two were excluded, one for conversion to open surgery, one for short follow up. Group
I consistent of the first 30 patients and Group II consisted of the next 33. A single surgeon performed
Group I’s surgeries and then proctored two of the other surgeons through some of Group II’s surger-
ies. Foley catheter was removed within 24 hours in all.
RESULTS
Group I included 11 females and mean age was 120.4 months (range 8-234). Average console time
was 98 minutes and length of stay was 1.4 days (1-3). There was a single Clavien IIIb complication
(open reoperation) and a single Clavien I complication (admission for nausea). Group II included
8 females and mean age was 102.3 months (11-245). Average console time was 78.3 minutes
and length of stay was 1.2 days (1-2). There were two Clavien IIIb complications (both required
stent repositioning due to pain or stent migration) and a single Clavien II complication (urinary tract
infection).
CONCLUSIONS
RP achieves results comparable to those reported for open and laparoscopic techniques. Despite
slightly longer surgical time in the first 30 patients, outcomes were similar and acceptable in both
groups. Establishing a pediatric robotic program can be achieved safely and effectively with
proctoring.
S15-13 (P without presentation)
OUTPATIENT TUBELESS ROBOTIC UPPER URINARY
TRACT RECONSTRUCTION: SHORT-TERM OUTCOME
ASSESSMENT OF SAFETY
Eric FICHTENBAUM, Andrew STRINE, Charles CONCODORA, Marion SCHULTE
and Paul NOH
Cincinnati Children’s Hospital Medical Center, Pediatric Surgery, Division of Pediatric Urology, Cincinnati, USA
PURPOSE
Robotic upper tract reconstruction has been established as a viable option for surgical management
of congenital upper urinary tract obstructions. To further reduce morbidity and simplify postopera-
tive care, robotic pyeloplasty (RP) and robotic ureteroureterostomy (RUU) were performed without
ureteral stents, drains, or urethral catheters. The aim of the study was to assess the feasibility and
safety of performing pediatric outpatient tubeless robotic upper urinary tract reconstruction.
MATERIAL AND METHODS
A retrospective review was performed from 2015-2016 of patients who underwent outpatient
tubeless RP and RUU. An interrupted anastomosis was performed for reconstruction. No internal
or external drains were utilized. No regional blocks were utilized. Patients were discharged from
the recovery room, without an extended stay, as a scheduled outpatient procedure. Postoperative
outcomes were assessed during the 30 days after surgery for perioperative morbidity including
emergency department (ED) visits, hospital readmission, or subsequent unplanned procedures.
RESULTS
A total of 16 patients were identified with 17 procedures (RP=14, RUU=3), including one patient who
underwent staged bilateral procedures. There were 11 males and 5 females. Median age (months)
and weight (kg) were 13.4 (range 3-99) and 10.5 (range 6.0-29.0), respectively. Median operative
time (minutes) was 164 (range 108-241), defined as skin incision to closure. No patient required ED
visit, hospital readmission, or unplanned surgical procedures.