Boysen William R, Gundeti Mohan S
Pediatric Urology, Comer Children's Hospital, The University of Chicago Medicine and Biological Sciences, 5841 S. Maryland, P-217, MC 7122, Chicago, IL, 60637, USA.
Pediatr Surg Int. 2017 Sep;33(9):925-935. doi: 10.1007/s00383-017-4082-7. Epub 2017 Apr 1.
Ureteropelvic junction obstruction is a common condition encountered by the pediatric urologist, and treated with pyeloplasty when indicated. Recent technological advancements and a shift across all surgical fields to embrace minimally invasive surgery have led to increased utilization of minimally invasive pyeloplasty. Conventional laparoscopy is a reasonable choice, but its use is limited by the technical challenges of precise suturing in a confined space and the associated considerable learning curve. Robotic technology has simplified the minimally invasive approach to pyeloplasty, offering enhanced visualization and improved dexterity with a fairly short learning curve. As utilization of robotic pyeloplasty continues to increase, we sought to critically assess the literature on this approach. We begin with a review of the technical aspects of robot-assisted laparoscopic pyeloplasty including tips for surgical proficiency and patient safety. Outcomes and complications from the contemporary literature are reviewed, as well as special considerations in the pediatric population including infant pyeloplasty, cost concerns, training, and postoperative diversion/drainage.
肾盂输尿管连接处梗阻是小儿泌尿外科医生常遇到的一种病症，在有指征时采用肾盂成形术进行治疗。近期的技术进步以及所有外科领域向微创手术的转变，导致微创肾盂成形术的应用增加。传统腹腔镜手术是一种合理的选择，但其应用受到在狭小空间内精确缝合的技术挑战以及相关的相当长学习曲线的限制。机器人技术简化了肾盂成形术的微创方法，提供了增强的可视化效果和更高的灵活性，且学习曲线相当短。随着机器人肾盂成形术的应用持续增加，我们试图严格评估关于这种方法的文献。我们首先回顾机器人辅助腹腔镜肾盂成形术的技术方面，包括手术熟练技巧和患者安全提示。回顾当代文献中的结果和并发症，以及小儿人群中的特殊考虑因素，包括婴儿肾盂成形术、成本问题、培训和术后引流。
