Chung Paul H, De Shuvro, Gargollo Patricio C
1 Division of Pediatric Urology, Children's Medical Center, University of Texas Southwestern Medical Center , Dallas, Texas.
J Endourol. 2015 Mar;29(3):271-5. doi: 10.1089/end.2014.0550. Epub 2014 Oct 30.
To report our initial results of robotic appendicovesicostomy (APV) revision in children.
Three patients (median age 6 years; range 6-13) underwent robot-assisted APV surgery for bladder dysfunction because of posterior urethral valves, myelomeningocele, and traumatic spinal cord transection. Leakage developed in each patient from the APV. After failing more conservative treatments, the patients subsequently underwent robot-assisted APV revision.
Robot-assisted APV revision was conducted at a median 14 months (range 6-34 mos) after initial surgery. Median operative time was 165 minutes (range 106-232 min), and blood loss was ≤5 mL for all patients. Intraoperative findings ranged from partial to complete separation of the APV from the bladder tunnel. APV leakage resolved for all patients at last follow-up (median 5 months; range 2-9 mos).
This initial series expands the scope of robotic surgical procedures in children. Robot-assisted APV revision was technically feasible and safe in this early experience.
报告我们在儿童中进行机器人辅助阑尾膀胱造口术（APV）修复的初步结果。
三名患者（中位年龄6岁；范围6 - 13岁）因后尿道瓣膜、脊髓脊膜膨出和创伤性脊髓横断导致膀胱功能障碍，接受了机器人辅助的APV手术。每名患者的APV均出现渗漏。在更保守的治疗失败后，这些患者随后接受了机器人辅助的APV修复术。
机器人辅助的APV修复术在初次手术后中位14个月（范围6 - 34个月）进行。中位手术时间为165分钟（范围106 - 232分钟），所有患者的失血量均≤5毫升。术中发现从APV与膀胱隧道的部分分离到完全分离不等。在最后一次随访时（中位5个月；范围2 - 9个月），所有患者的APV渗漏均得到解决。
这一初步系列扩展了儿童机器人手术程序的范围。在这一早期经验中，机器人辅助的APV修复术在技术上是可行且安全的。
