Robot-assisted bladder diverticulectomy in the pediatric population

Background and Purpose: Surgical intervention is warranted for symptomatic congenital bladder diverticula (CBD) in children. We hypothesized that a robot-assisted approach to bladder diverticulectomy could be performed with safety and with good efficacy. Descriptions of our approach and results with robot-assisted laparoscopic bladder diverticulectomy (RALBD) are presented. Patients and Methods: We retrospectively reviewed a prospective database with Institutional Review Board approval. Eligible patients were those who underwent excision of a bladder diverticulum via a robotic approach. Data were collected on presenting symptoms, and intraoperative and postoperative courses. Voiding cystourethrography (VCUG) was performed at 3-month follow-up. Renal and bladder ultrasonography was performed at 3-and 12-month follow-up. Results: Fourteen patients were identified. Of the 14 patients, 6 also had a history of diurnal enuresis. Mean patient age was 7.9 years (range 4-13 years). The operation was performed via a transperitoneal approach with robot assistance. The mean operative time (including cystoscopy) was 132.7 minutes (range 113-192min). The average length of stay was 24.4 hours (range 18-31 hours). There were no intraoperative or postoperative complications in this group. Each patient was followed for at least 1 year. All patients had a normal results of VCUG on follow-up without evidence of a diverticulum. Within 3 months, diurnal enuresis resolved in 6/6 patients. Conclusions: RALBD appears to be a safe and effective modality for treatment of patients with CBD. It can serve as an alternative to the open surgical approach.