The University of Chicago Medicine & Biological Sciences, Comer Children's Hospital, Chicago, IL 60637, USA.
Curr Urol Rep. 2013 Aug;14(4):333-41. doi: 10.1007/s11934-013-0328-7.
Open surgery has long been the most common surgical approach for the correction of congenital anomalies of the lower urinary tract in children. With the continued development of minimally invasive surgery in adult urology, including endoscopic, conventional, and robot-assisted laparoscopic approaches, the indications for minimally invasive surgery have similarly expanded in the pediatric population. The most commonly performed robotic procedure in children has been pyeloplasty for ureteropelvic junction obstruction; the use of robotics in complex reconstructive surgery in the lower urinary tract has also been acceptable. In this review, we summarize recent viewpoints regarding robotic-assisted laparoscopic reconstructive surgeries in the lower urinary tract, such as ureteral reimplantation, appendicovesicostomy, and augmentation enterocystoplasty in the pediatric population, and critically summarize the current knowledge on outcomes in the literature. We also discuss our technique and the outcomes of robotic ureteral reimplantation. This review demonstrates that robotic-assisted laparoscopic reconstructive surgeries in the lower urinary tract are technically feasible and may achieve outcomes that are equalto those of open surgery, with reduced morbidity.
开放手术长期以来一直是儿童下尿路先天性异常矫正的最常见手术方法。随着成人泌尿科微创技术的不断发展,包括内镜、传统和机器人辅助腹腔镜方法,微创治疗的适应证在儿科人群中也同样得到了扩展。儿童最常进行的机器人手术是肾盂成形术治疗肾盂输尿管连接部梗阻;机器人在复杂的下尿路重建手术中的应用也是可以接受的。在这篇综述中,我们总结了最近关于机器人辅助腹腔镜下尿路重建手术的观点,例如儿童的输尿管再植术、阑尾膀胱吻合术和膀胱扩大肠膀胱成形术,并批判性地总结了文献中关于结果的现有知识。我们还讨论了我们的技术和机器人输尿管再植术的结果。这篇综述表明,机器人辅助腹腔镜下尿路重建手术在技术上是可行的,并且可能达到与开放手术相当的结果,同时减少了发病率。