Robotic-assisted laparoscopic bladder augmentation in the pediatric patient

• 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
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2016.06.004

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.