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• W2000228811 abstract "No AccessJournal of UrologyReconstruction1 May 2015Multi-Institutional Review of Outcomes of Robot-Assisted Laparoscopic Extravesical Ureteral Reimplantation Gwen M. Grimsby, Moira E. Dwyer, Micah A. Jacobs, Michael C. Ost, Francis X. Schneck, Glenn M. Cannon, and Patricio C. Gargollo Gwen M. GrimsbyGwen M. Grimsby Division of Pediatric Urology, Department of Urology, University of Texas Southwestern Medical Center and Children’s Medical Center, Dallas, Texas More articles by this author , Moira E. DwyerMoira E. Dwyer Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author , Micah A. JacobsMicah A. Jacobs Division of Pediatric Urology, Department of Urology, University of Texas Southwestern Medical Center and Children’s Medical Center, Dallas, Texas Financial interest and/or other relationship with Terumo. More articles by this author , Michael C. OstMichael C. Ost Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author , Francis X. SchneckFrancis X. Schneck Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author , Glenn M. CannonGlenn M. Cannon Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author , and Patricio C. GargolloPatricio C. Gargollo Texas Children’s Hospital-Baylor College of Medicine, Houston, Texas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.07.128AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We performed a multi-institutional assessment of the outcomes and complications of robot-assisted laparoscopic extravesical ureteral reimplantation for vesicoureteral reflux in children. Materials and Methods: We retrospectively reviewed the records of patients who underwent robot-assisted laparoscopic extravesical ureteral reimplantation as done by 1 of 5 surgeons at Children’s Medical Center, Dallas, Texas, or Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, from 2010 to 2013. Procedure failure was defined as persistent vesicoureteral reflux on postoperative voiding cystourethrogram or radionuclide cystogram and/or the need for reoperation. Multivariate logistic regression was done to identify possible risk factors for failure using STATA®, version 11. Results: A total of 61 patients (93 ureters) with a mean age of 6.7 years (range 0.6 to 18.0) underwent a procedure, of which 32 (52%) were bilateral. Ten patients (16%) underwent previous subureteral injection for vesicoureteral reflux. At a mean followup of 11.7 months the procedure was successful in 44 of 61 patients (72%). There were 14 cases of persistent vesicoureteral reflux (23%), 6 complications (10%) and 9 reoperations (11%). Multivariate logistic regression identified no factor that increased the risk of failure (p = 0.737). Conclusions: Compared to the literature we found a notably lower success rate for robot-assisted laparoscopic extravesical ureteral reimplantation in the hands of 5 fellowship trained, robotically experienced pediatric urologists. More than 10% of patients required at least 1 reoperation for persistent vesicoureteral reflux or a surgical complication. Our experience suggests a higher complication rate and a lower success rate for robot-assisted laparoscopic ureteral reimplantation compared to the gold standard of open reimplantation. References 1 : Vesicoureteral reflux: current trends in diagnosis, screening, and treatment. Eur Urol2012; 61: 773. Google Scholar 2 : Current surgical management of vesicoureteral reflux. Korean J Urol2013; 54: 732. Google Scholar 3 : Robotic-assisted laparoscopic reconstructive surgery in the lower urinary tract. Curr Urol Rep2013; 14: 333. Google Scholar 4 : Robot-assisted laparoscopic urological surgery in children. Nat Rev Urol2013; 10: 632. Google Scholar 5 : Robotic assisted ureteral reimplantation: current status. Curr Urol Rep2013; 14: 32. Google Scholar 6 : Parent and patient perceptions of robotic vs open urological surgery scars in children. J Urol2013; 190: 244. 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Link, Google Scholar © 2015FiguresReferencesRelatedDetailsCited byJohnson E, Chalmers D, Nelson C, Li I, Iwaniuk M, Grant C, Byrd C, Rangel S, Saito J, Barnhart D, Hall B, Vemulakonda V, Groth T, Ellison J, Janzen N, Hittelman A, DiCarlo H, Merguerian P, Tanaka S and Prasad M (2020) Antireflux Surgery at National Surgical Quality Improvement Program-Pediatric HospitalsJournal of Urology, VOL. 205, NO. 4, (1189-1198), Online publication date: 1-Apr-2021.Aksenov L, Granberg C and Gargollo P (2019) A Systematic Review of Complications of Minimally Invasive Surgery in the Pediatric Urological LiteratureJournal of Urology, VOL. 203, NO. 5, (1010-1016), Online publication date: 1-May-2020.Gargollo P, Granberg C, Gong E, Tu D, Whittam B and Dajusta D (2018) Complex Robotic Lower Urinary Tract Surgery in Patients with History of Open SurgeryJournal of Urology, VOL. 201, NO. 1, (162-168), Online publication date: 1-Jan-2019.Jimbo M, Granberg C, Osumah T, Bandari J, Cannon G, Routh J and Gargollo P (2019) Discrepancies in Self-Reported and Actual Conflicts of Interest for Robotic Pediatric Urological SurgeryJournal of Urology, VOL. 201, NO. 2, (393-399), Online publication date: 1-Feb-2019.Schlussel R (2019) Editorial CommentJournal of Urology, VOL. 201, NO. 3, (619-619), Online publication date: 1-Mar-2019.Routh J (2016) Editorial CommentJournal of Urology, VOL. 197, NO. 3 Part 2, (917-918), Online publication date: 1-Mar-2017.Boysen W, Ellison J, Kim C, Koh C, Noh P, Whittam B, Palmer B, Shukla A, Kirsch A and Gundeti M (2017) Multi-Institutional Review of Outcomes and Complications of Robot-Assisted Laparoscopic Extravesical Ureteral Reimplantation for Treatment of Primary Vesicoureteral Reflux in ChildrenJournal of Urology, VOL. 197, NO. 6, (1555-1561), Online publication date: 1-Jun-2017.Bowen D, Faasse M, Liu D, Gong E, Lindgren B and Johnson E (2016) Use of Pediatric Open, Laparoscopic and Robot-Assisted Laparoscopic Ureteral Reimplantation in the United States: 2000 to 2012Journal of Urology, VOL. 196, NO. 1, (207-212), Online publication date: 1-Jul-2016.Lindgren B (2015) Appendicovesicostomy—What is the Best Technique for a Good Operation?Journal of Urology, VOL. 194, NO. 3, (617-618), Online publication date: 1-Sep-2015. Volume 193Issue 5SMay 2015Page: 1791-1795 Advertisement Copyright & Permissions© 2015Keywordsreplantationroboticlaparoscopyvesico-ureteral refluxureterMetricsAuthor Information Gwen M. Grimsby Division of Pediatric Urology, Department of Urology, University of Texas Southwestern Medical Center and Children’s Medical Center, Dallas, Texas More articles by this author Moira E. Dwyer Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author Micah A. Jacobs Division of Pediatric Urology, Department of Urology, University of Texas Southwestern Medical Center and Children’s Medical Center, Dallas, Texas Financial interest and/or other relationship with Terumo. More articles by this author Michael C. Ost Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author Francis X. Schneck Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author Glenn M. Cannon Department of Urology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania More articles by this author Patricio C. Gargollo Texas Children’s Hospital-Baylor College of Medicine, Houston, Texas More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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