Robotic partial nephrectomy is a complex minimally invasive procedure that addresses the intricate anatomy of renal masses while maximizing preservation of renal function. However, while common in adults, the evolution toward these minimally invasive procedures for children has been slow due to the anticipated technical difficulties in pediatric-sized working spaces. We present our technique and our experience with pediatric robotic partial nephrectomies that were performed with our adult urology colleagues at a large free-standing children's hospital.
The video describes our technique for a robotic right-sided partial nephrectomy in a 14-month-old male patient. The video highlights several steps of the procedure including positioning and port placement, tumor resection, and renorrhaphy.
Six pediatric patients underwent robotic partial nephrectomy with our associated adult urologic surgeons from January 2019 to January 2021. The surgical pathology revealed both benign as well as malignant diagnoses.
Robotic partial nephrectomy is a feasible minimally invasive procedure in children. The collaboration with adult minimally invasive urologic surgeons with extensive adult procedural experience is recommended to avoid potential complications with this technically challenging procedure in pediatric patients. Pediatric strategies for robotic port placement are often needed to accommodate the smaller size of pediatric patients as well as tumor size.
Journal of pediatric urology. 2022 Jul 02 [Epub ahead of print]
Ali Antar, Hannah Agard Bachtel, Jenna N Bates, Soo Jeong Kim, Asad Saleem, Vinaya Bhatia, Richard E Link, Chester J Koh
Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, USA., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, USA; Department of Urology, University of Wisconsin-Madison, Madison, WI, USA., Division of Endourology and Minimally-Invasive Surgery, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.