Pediatric robot-assisted pyeloplasty

The emergence of robot-assisted surgical technology has permitted application of laparoscopic pyeloplasty to the pediatric age group to a much wider degree than previously possible. The challenging learning curve for conventional laparoscopic pyeloplasty, particularly in infants, has hindered its widespread application. Robot-assisted pyeloplasty in children has been clearly shown to provide an equally effective, safe, and reasonably efficient means to repair ureteropelvic junction obstruction with more rapid hospital discharge and less postoperative analgesic requirements. Precise port placement, adjusted to the child's anatomy and size, delicate anastomosis, and use of postoperative stent appear to be important elements for successful repair. The procedure has become reproducible and in some centers is exclusively used over open repair. The specific procedural steps are detailed and the potential limitations and complications are reviewed, as well as the limited available data in the literature.