Robotic pyeloplasty in the pediatric population

The procedure most performed with the da Vinci system (Intuitive Surgical, Sunnyvale, CA) in pediatric urology is pyeloplasty for ureteropelvic junction obstruction. As with laparoscopic pyeloplasty, robotic-assisted pyeloplasty (RAP) can be performed by a trans- or retroperitoneal approach. Suturing is done with a 6-0 monofilament absorbable suture, but any 5-0 or 6-0 suture can be used depending on the size of the patient. Currently, it appears that nothing larger than 6-0 is recommended for small children and infants. RAP in children has been demonstrated to be feasible and to have satisfactory results. Although there are only a few published series on the long-term outcome to date, the short-term data suggest that outcomes are similar to those of open pyeloplasty in children, and it appears to be more than promising.