Comparative study of open and robot-assisted approaches to ureteropelvic junction obstruction in children ≤ 12 months: A multi-institutional retrospective analysis.

Background: The utilization of robot-assisted laparoscopic pyeloplasty (RALP) for the surgical correction of ureteropelvic junction obstruction (UPJO) continues to increase. The aim of this study was to determine whether robot-assisted laparoscopic pyeloplasty (RALP) is a safe and equally efficacious procedure compared to open pyeloplasty (OP) in infants ≤12 months old.

Methods: All patients ≤12 months old who underwent RALP or OP between January 2012 and January 2021 at five participating centers were included in this study.

Minimally invasive approach to retroperitoneal lymph node dissection in pediatric paratesticular rhabdomyosarcoma: A multi-institutional case series.

Introduction: Retroperitoneal lymph node dissection (RPLND) is a critical surgical procedure for staging and managing paratesticular rhabdomyosarcoma (RMS) in pediatric patients. While minimally invasive surgical (MIS) approaches, including laparoscopic (LP) and robot-assisted (RA) techniques, are well-documented in adult populations, their utilization in pediatric patients remains limited. This multi-institutional study evaluates perioperative and long-term outcomes of MIS RPLND compared to open RPLND in children with PT-RMS.

Does incontinence in a child with bladder exstrophy negatively affect caregivers? A mental health inventory survey.

Introduction: Urinary continence is a goal of bladder exstrophy epispadias complex (BEEC) surgical management. However, it is often not achieved until school age or later. Little is known about the mental health implications of this incontinence on caregivers and whether this should affect timing of surgical interventions to achieve continence.

Ureteroureterostomy as Definitive Intervention for Duplex Anomalies: A Mid-Term Analysis.

Objective: To provide a mid-term evaluation-defined as 3 to 10 years of post-operative follow up-of children with duplicated collecting systems undergoing ureteroureterostomy. In addition, a sub stratified analysis based on surgical approach is delivered to compare outcomes between the two approaches.

Materials And Methods: An IRB-approved single-institutional registry was retrospectively reviewed to identify all patients undergoing ureteroureterostomy (UU) for duplex renal anomalies between 2014 and 2020.

Comparison of open and robot-assisted repair for ureteropelvic junction obstruction: Outcomes and direct costs from a single-institution.

Introduction: Robot-assisted laparoscopic pyeloplasty (RALP) is commonly performed to repair ureteropelvic junction obstruction (UPJO), but concerns remain regarding its efficacy and safety, as well as its cost compared to open pyeloplasty (OP). We hypothesized that primary RALP is equally efficacious to OP, with comparable direct costs.

Methods: An IRB-approved single institutional registry was retrospectively reviewed to identify all patients undergoing primary OP and RALP between July 2012 and March 2020.

Management of urachal anomalies in children: insights from a retrospective cohort study.

Introduction: While large and symptomatic urachal anomalies (UAs) often lead to surgical excision, urachal malignancy is rare, rendering prophylactic excision unwarranted. We hypothesize that in the pediatric population, the presentation of an infected UA is the predominant etiology leading to surgical intervention.

Methods: We retrospectively identified patients with UA from July 2012 to December 2021 evaluated in our urology outpatient.

Comparative Analysis of Efficacy and Complications of Robot-Assisted Open Dismembered Ureteral Reimplantation for Primary Obstructive Megaureter.

Dismembered ureteral reimplant (DUR) is done to treat primary obstructive megaureter (POM). To describe and compare outcomes between open dismembered ureteral reimplant (ODUR) robot-assisted laparoscopic dismembered ureteral reimplant (RALDUR). An IRB-approved registry was used to retrospectively identify all patients who underwent DUR for POM between 2015 and 2022.

Is robot-assisted appendicovesicostomy equivalent to the current gold standard open procedure? A comparative analysis.

Introduction: Robot-assisted Laparoscopic Appendicovesicostomy (RALAPV) is increasingly performed as a minimally invasive alternative to the open appendicovesicostomy (OPAV), but questions remain regarding the efficacy of the RALAPV compared to OPAV.

Objective: To assess and compare outcomes for non-augmented RALAPV to the open surgical approach.

Materials And Methods: An IRB approved prospective registry was retrospectively examined to abstract all patients who underwent APV without augment between 2012 and 2023.

The missed crossing vessel during open pyeloplasty: a potential advantage of the robot-assisted approach in children.

Objective: To investigate whether the panoramic view offered by robot-assisted laparoscopic pyeloplasty (RALP) reduces the likelihood of missing a crossing vessel compared to open pyeloplasty in cases where initial pyeloplasty fails.

Methods: A single institution redo-pyeloplasty database was reviewed for children treated between January 2012 to July 2023. Clinical history, imaging and operative details were reviewed to identify the etiology for the redo procedure.

Unmasking Ureteral Polyps: Insights From a Case Series.

Fibroepithelial polyps in the urinary tract are a rare cause of obstructive uropathy with fewer than 130 cases reported in the literature. In our series, we describe polyps that were missed on preoperative imaging and later found in the operating room during pyeloplasty. It is critical for urologists to be aware of polyps as a potential source of obstruction as they can increase the complexity of a reconstruction and, if missed, may result in a failed repair and persistent obstruction.

Multi-Institutional Bladder Exstrophy Consortium After 8 Years: The Short- and Intermediate-Term Outcomes.

Purpose: Bladder exstrophy (BE) poses challenges both during the surgical repair and throughout follow-up. In 2013, a multi-institutional BE consortium was initiated, which included utilization of unified surgical principles for the complete primary repair of exstrophy (CPRE), real-time coaching, ongoing video capture and review of video footage, prospective data collection, and routine patient data analysis, with the goal of optimizing the surgical procedure to minimize devastating complications such as glans ischemia and bladder dehiscence while maximizing the rate of volitional voiding with continence and long-term protection of the upper tracts. This study reports on our short-term complications and intermediate-term continence outcomes.

Pediatric Robot-Assisted Laparoscopic Pyeloplasty: Where Are We Now?

Purpose Of Review: This review aims to provide an in-depth exploration of the recent advancements in robot-assisted laparoscopic pyeloplasty (RALP) and its evolving landscape in the context of infant pyeloplasty, complex genitourinary (GU) anatomy, recurrent ureteropelvic junction (UPJ) obstruction, cost considerations, and the learning curve.

Recent Findings: Recent literature highlights the safety and efficacy of RALP in treating the infant population, patients with complex GU anomalies, and recurrent UPJO which were all traditionally managed using the open approach. Cost considerations are evolving, with the potential for RALP to have a lesser financial burden.

The impact of AirSeal on complications and pain management during robotic-assisted radical prostatectomy: a single-tertiary center study.

Purpose: We aimed to compare perioperative outcomes, post-operative complications, and opioid use between AirSeal and non-AirSeal robotic-assisted radical prostatectomy (RARP).

Methods: We retrospectively collected data on 326 patients who underwent elective RARP at our institution either with or without AirSeal. The first 60 cases were excluded accounting for the institutions' learning curve of RARP.

Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program.

Background: The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures.

Objectives: We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy.

Design And Methods: Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017.

Telemedicine and Telementoring in Urology: A Glimpse of the Past and a Leap Into the Future.

Telemedicine is the process of utilizing telecommunications and digital relay to perform, teach, or share medical knowledge. The digital era eased the incorporation of telemedicine to different areas of medical care, including the surgical care of Urologic patient mainly through telementoring, telesurgery, and telerobotics. Over the years, Telemedicine has played an integral part in a physicians' ability to provide high quality medical care to remote patients, as well as serve as an educational tool for trainee physicians, in the form of telementoring.