Robotic-assisted Laparoscopic Surgery in Pediatric Urology: Capacity Building and Reflecting on Five Years’ Experience in West Virginia

Abstract

Robotic surgery was born at the turn of the millennium as it was first approved by the US food and Drug Administration in 2000 with the introduction of the da Vinci (Intuitive Surgical, Inc., Mountain View, Ca) robotic surgical platform. However, its adoption by pediatric urologists did not occur until 2002, and even then it was used by only a select handful of surgeons. While the use of robotics in pediatric urology has grown steadily worldwide, its implementation in treating pediatric urology patients in West Virginia has been much slower. Reasons for this are twofold: historically, the lack of pediatric urology capability in the state, and comfort with the technology. The efforts in building a pediatric urologic robotics program at WVU are evident in the success of the program thus far. To date, 86 robotic urology cases have been performed in pediatric patients. Importantly, we report no significant complications (Clavien-Dindo Classification 2 or more) and no open conversions for our cohort. Demographically, the average age for our population at date of surgery was 8 years (range 1-19 years) with an average weight of 31.3 kg (10.3-74.7 kg). Intraoperatively, the average duration of surgery (cut-to-close) was 247.6 minutes with minimal blood loss and no patient requiring transfusion. Postoperatively, patients in our group did great, with an average length of hospitalization of 29.71 hours. We hope that our success may serve as an example of implementing robotics within other pediatric specialties where robotic implementation has been slow.

Keywords

• Robotic Surgery
• Pediatric Urology
• Pediatrics