Division of Pediatric Urology, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
J Endourol. 2012 Oct;26(10):1296-300. doi: 10.1089/end.2012.0051. Epub 2012 Sep 25.
Surgical intervention is warranted for symptomatic congenital bladder diverticula (CBD) in children. We hypothesized that a robot-assisted approach to bladder diverticulectomy could be performed with safety and with good efficacy. Descriptions of our approach and results with robot-assisted laparoscopic bladder diverticulectomy (RALBD) are presented.
We retrospectively reviewed a prospective database with Institutional Review Board approval. Eligible patients were those who underwent excision of a bladder diverticulum via a robotic approach. Data were collected on presenting symptoms, and intraoperative and postoperative courses. Voiding cystourethrography (VCUG) was performed at 3-month follow-up. Renal and bladder ultrasonography was performed at 3- and 12-month follow-up.
Fourteen patients were identified. Of the 14 patients, 6 also had a history of diurnal enuresis. Mean patient age was 7.9 years (range 4-13 years). The operation was performed via a transperitoneal approach with robot assistance. The mean operative time (including cystoscopy) was 132.7 minutes (range 113-192 min). The average length of stay was 24.4 hours (range 18-31 hours). There were no intraoperative or postoperative complications in this group. Each patient was followed for at least 1 year. All patients had a normal results of VCUG on follow-up without evidence of a diverticulum. Within 3 months, diurnal enuresis resolved in 6/6 patients.
RALBD appears to be a safe and effective modality for treatment of patients with CBD. It can serve as an alternative to the open surgical approach.
对于有症状的先天性膀胱憩室（CBD）患儿，手术干预是必要的。我们假设机器人辅助膀胱憩室切除术可以安全有效地进行。本文介绍了我们采用机器人辅助腹腔镜膀胱憩室切除术（RALBD）的方法和结果。
我们回顾性分析了经机构审查委员会批准的前瞻性数据库。符合条件的患者是通过机器人手术切除膀胱憩室的患者。收集了患者的主要症状、手术过程和术后过程的数据。所有患者在术后 3 个月进行排尿性膀胱尿道造影（VCUG）检查，术后 3 个月和 12 个月进行肾脏和膀胱超声检查。
共纳入 14 例患者，其中 6 例患者还伴有日间遗尿史。患者的平均年龄为 7.9 岁（4-13 岁）。手术均采用经腹腔机器人辅助入路。平均手术时间（包括膀胱镜检查）为 132.7 分钟（113-192 分钟）。平均住院时间为 24.4 小时（18-31 小时）。该组患者无术中或术后并发症。所有患者均随访至少 1 年。所有患者的 VCUG 随访结果均正常，无憩室证据。在 3 个月内，日间遗尿在 6/6 例患者中得到缓解。
RALBD 似乎是治疗 CBD 患者的一种安全有效的方法。它可以替代开放手术。
