ESPU Congress 2017 - Abstract book

284

CONGRESS OF THE ESPU

RALAUS was performed with a dissection of the bladder neck after opening of the endopelvic

fascia. A posterior plane was also created between the bladder and the vagina to complete the

dissection circumferentially around the bladder neck.

The bladder neck diameter was measured and the corresponding cuff was wrapped around it. The

cuff and reservoir tubing were brought out of the body and the peritoneum was closed keeping all

AUS parts extraperitoneally.

RESULTS

At 3-month follow-up, the patient has remained dry in between voids and both her and her family

are satisfied.

CONCLUSIONS

To our knowledge, this is the first described case of a RALAUS placement in children. We believe

this can be safely accomplished with good outcomes and it provides an advantage for deep pelvic

surgery as well as when concomitant intra-abdominal procedures are planned.

VS-7 (VS without presentation)

ROBOTIC PARTIAL NEPHRECTOMY IN A CHILD

WITH KIDNEY TUMOR

Sibel TIRYAKI

, Burak TURNA

, Erkan KISMALI

, Ali AVANOGLU

and Ibrahim ULMAN

1) Ege University-faculty of Medicine, Department of Pediatric Surgery, Division of Pediatric Urology, Izmir, TURKEY -

2) Ege University, Urology, Izmir, TURKEY - 3) Ege University, Radiology, Izmir, TURKEY - 4) Ege University, Pediatric

Surgery Division of Pediatric Urology, Izmir, TURKEY

PURPOSE

Robotic surgery is gaining wider utility in adults; however, few reports have addressed the applica-

bility of robotic surgery for renal tumors in children. The aim of this report is to share our experience

in an 8 year-old child with a renal tumor. To our knowledge, this is the youngest case of robotic

partial nephrectomy in the literature.

CASE

A 8-year-old girl presented with abdominal pain. MRI showed a 24x23x19 mm solid tumor with

cystic areas restricted to the upper pole of left kidney. The mass was well-demarcated with benign

features and without any signs of a malignant mass or angiomyolipoma. Left robotic partial nephrec-

tomy was planned. There was no postoperative complications. Pathological evaluation revealed

metanephric stromal tumor. The patient was discharged on postoperative day three, postoperative

6 months follow-up is event-free.

OPERATIVE DETAILS

The patient was placed in a 30-degree right decubitus position. A 12 mm trocar for the camera from

the umbilicus, two 8 mm trocars for robotic arms, and two additional trocars for assistance were

introduced. Descending colon was reflected medially to reach retroperitoneal space. Resection

margins were evaluated using endoscopic ultrasonography. Renal artery was controlled using

endo-bulldog clamps. Mass was totally resected with a safe rim of renal parenchyma. Tumor bed

was repaired using 3/0 V-loc and vicryl sutures. Duration of the operation was 160 minutes and

warm ischemia time was 21 minutes. Blood loss was 20 ml.

CONCLUSIONS

There is a worldwide tendency to perform minimal invasive surgery for kidney tumors. Partial

nephrectomy can be done open leaving an unsightly long scar. Robotic partial nephrectomy is

superior to laparoscopy regarding safety and handling especially during renal vascular control and

resection. In the presence of an experienced team and proper conditions, we believe robotic partial

nephrectomy will be the preferred option in future.