Robot-assisted laparoscopic pyeloplasty tied to better recovery in kids

For the treatment of ureteropelvic junction obstruction (UPJO) in infants and young children, robotic-assisted laparoscopic pyeloplasty (RALP) leads to less trauma and better recovery while reaching comparable efficacy as conventional LP, a recent study has found.

Researchers conducted a retrospective analysis of 33 UPJO patients aged 0–36 months. Twelve were treated with RALP while the remaining 21 underwent conventional LP. In the corresponding groups, the mean operation times were 120.25 and 156.10 minutes, while average hospital stays were 6.42 and 8.19 days. In both cases, RALP was statistically superior than the conventional procedure (p=0.042 and p=0.023, respectively).

The amount of bleeding during the procedure was comparable between treatment arms, as was postoperative pain, as measured by the Face, Legs, Activity, Cry, Consolability scale, with mean scores of 2.08 vs 2.00 in the RALP vs LP groups, respectively (p=0.89).

Preoperatively, RALP patients had an anteroposterior diameter of 3.29 cm, which decreased to 2.19 and 1.30 cm at 3 and 6 months, respectively, after the procedure. Meanwhile, parenchymal thickness increased from 0.32 cm before surgery to 0.52 cm at 3 months and 0.65 cm at 6 months. Improvements in both metrics were deemed statistically significant.

RALP had a success rate of 100 percent, as opposed to 95.2 percent in the conventional LP arm. There were no short-term complications reported.

“RALP with the fourth-generation surgery system has several advantages compared to LP in terms of trauma, recovery time, and safety. Its effectiveness for treating UPJO in infants and younger children is comparable to that of LP,” the researchers said.

“This may set the trend for minimally invasive surgery in the future,” they added.