Robotic-assisted laparoscopic bladder augmentation in the pediatric patient

Abstract Introduction Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient. Methods...

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Bibliographic Details
Published in:Journal of pediatric urology 2016-10, Vol.12 (5), p.313.e1-313.e2
Main Authors: Wiestma, A.C, Estrada, C.R, Cho, P.S., M.D, Hollis, M.V, Yu, R.N
Format: Article
Language:English
Subjects:
Bladder augmentation
Child
Humans
Laparoscopy
Male
Neurogenic bladder
Pediatrics
Robotic surgery
Robotic Surgical Procedures
Spina bifida
Urinary Bladder - surgery
Urinary Bladder, Neurogenic - surgery
Urologic Surgical Procedures - methods
Urology
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Summary:Abstract Introduction Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient. Methods The patient was a 6 year old (18.5 kg) boy with a neurogenic bladder secondary to lumbar myelomeningocele. Urodynamics revealed a small capacity and poorly compliant bladder and he was incontinent between frequent catheterizations. A robotic augmentation cystoplasty was performed. Results At one-month postoperatively, a cystogram revealed no urine leak, and the suprapubic tube was removed. The patient resumed CIC every 3 hours during the day and once overnight until postoperative urodynamic studies confirmed safe dynamics, after which the CIC interval was lengthened. Conclusion Robotic bladder augmentation is safe and feasible in a select pediatric population. The entire procedure including preparation of the bowel segment can be completed intracorporeally, even in smaller children.
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2016.06.004