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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Urology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1470948
This article is part of the Research Topic Robotic Assisted Laparoscopic Surgery (RALS) in Pediatric Urology, Volume II View all 3 articles

Robot-assisted laparoscopic ipsilateral ureteroureterostomy for duplex kidneys in children: preliminary single-center experience

Provisionally accepted
Chao Yang Chao Yang 1Chi Zhang Chi Zhang 2Yongsheng Cao Yongsheng Cao 3Qi-fei Deng Qi-fei Deng 3Mao Chang Kun Mao Chang Kun 3*
  • 1 Department of Urology, Anhui Provincial Children’s Hospital, Hefei, China
  • 2 Anhui Chest Hospital, Hefei, Anhui Province, China
  • 3 Anhui Provincial Children’s Hospital, Hefei, China

The final, formatted version of the article will be published soon.

    Objective: This study evaluates the efficacy and safety of robot-assisted laparoscopic ipsilateral ureteroureterostomy (RAL-IUU) in treating children with duplex kidney ureteral malformations by detailing our early single-center experience. Materials and methods: We conducted a retrospective analysis of clinical data from 14 children with complete duplex kidney ureteral malformations treated with RAL-IUU at our institution from December 2021 to January 2024. Clinical data included patient demographics, surgical details, and postoperative outcomes. Results: The operation time averaged 128.71±22.35 minutes in 14 cases, intraoperative blood loss was 7.57±2.77 ml, drainage tube placement lasted for 3.14±0.66 days, and hospital stay averaged 4.79±0.70 days. Stent placement lasted 43.58±6.33 days. Notable changes were observed in the upper moiety anterior-posterior diameter (APD) before and after surgery (23.84±8.05 mm vs. 6.71±2.20mm, P<0.001), diameter at the widest part of the upper moiety ureter (15.58±6.07mm vs. 4.61±0.78mm, P<0.001), and split renal function of the upper moiety (12.28±3.04% vs. 16.50±2.75%, P<0.001). Postoperative follow-up ranged from 6 to 18 months; during the period with a D-J stent, one case developed a urinary tract infection, one case had recurrent gross hematuria, and another child exhibited significant urinary irritative symptoms (frequency), with an abdominal plain film revealing that the D-J tube had descended completely into the bladder, and symptoms disappeared after the removal of the D-J tube. During the follow-up period post-D-J tube removal, none of the 14 children experienced a urinary tract infection again during the follow up period, urinary incontinence ceased. Conclusion: RAL-IUU provides an excellent surgical field and operating space, precise suturing, and minimal surgical trauma. Postoperatively, there is a reduction in renal pelvis and ureteral hydronephrosis, recovery of split renal function, and minimal complications all with rapid recovery. RAL-IUU is a safe and feasible treatment option for children with complete duplex kidneys.

    Keywords: robotic surgery, Duplex kidney, Duplicated ureter, Ipsilateral ureteroureterostomy, RAL-IUU

    Received: 26 Jul 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Yang, Zhang, Cao, Deng and Chang Kun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mao Chang Kun, Anhui Provincial Children’s Hospital, Hefei, China

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