ESPU Congress 2018 - Abstract Book

116 29 th CONGRESS OF THE ESPU 08:58–09:01 S14-3 (PP) RETROPERITONEAL APPROACH FOR URETEROPELVIC JUNCTION OBSTRUCTION: MOVING FROM LAPAROSCOPIC TO ROBOT-ASSISTED LAPAROSCOPIC REPAIR. PRELIMINARY RESULTS Thomas BLANC, Pauline CLERMIDI, Henri LOTTMANN, Nathalie BOTTO, Luca PIO and Yves AIGRAIN Hôpital Necker - Enfants Malades, Department of Pediatric Surgery and Urology, Paris, FRANCE PURPOSE Robot-assisted laparoscopic pyeloplasty (RALP) has been gaining acceptance among pediatric urologists. Few studies have evaluated the retroperitoneal approach of RALP. Our aim was to evalu- ate our preliminary results in terms of safety and efficacy during the first year of a muldisciplinary paediatric robotic program. MATERIAL AND METHODS We performed a prospective analysis of children undergoing RALP for ureteropelvic junction ob- struction (n=22). The diagnosis of ureteropelvic junction obstruction was confirmed by ultrasound and Tc-99m mercaptoacetyltriglycine renal scan or MRI; same criteria were used to evaluate the outcome. The retroperitoneal approach was done according to specific algorithm. Transperitoneal approch (n: 8) was chosen for horseshoe kidney, ectopic kidney, and redo surgery. We analysed the 14 cases done through the lateral retroperitoneal approach. Dismembered pyeloplasty was done for all, anastomosis was performed using a running monofilament 6/0 absorbable suture. All were drained by double J. We evaluated operating room parameters and complication rates. RESULTS Mean age was 9 years (3–16) and mean weight was 30 kg (15–55). Mean set-up time, from skin incision until the end of docking, was 1 hour (47–82 min). Mean surgeon’s console time was 169 min (108–300). No conversion to an open operation was necessary. The postoperative course was free of complications. All the patients but one were discharged on day one. Mean follow-up was 6 months (1–10). Redo pyeloplasty was not needed. Transmission to trainees was feasible only after 10 cases done by the same surgeon. CONCLUSIONS These early results suggest that retroperitoneal RALP in children is feasible, safe and effective; a longer term follow-up is awaited.