V7-03: Complete Robotic Reconstruction for Pediatric Neurogeinc Bowel and Bladder

Video

INTRODUCTION

Robotic tecnologies continue to evolve for the surgical management of disorders of the urinary tract. Although individual procedures such as laparoscopic or robotic ileocystoplasty, appendico-vesicostomy, bladder neck sling and cecostomy have all been described, these procedures are rarely performed independently. We present an educational video of our technique for combining these procedures for the pediatric age group.

METHODS

Since 2012, patients have been offered robot-assisted laparoscopic reconstruction for the surgical management of complex neurogenic bowel and bladder dysfunction. All cases involved at least three of the above aforementioned procedures performed at the same sitting. Cases were performed by laparoscopy with the aid of the Da vinci robot using 4 robot ports and a single 12mm assistant port.

RESULTS

Eleven patients mean age 10+/-3 years of age have undergone complete robotic reconstruction for neurogenic bowel and bladder at our institution. Median follow up 15 months. None required conversion to open surgery. Median operative duration 7.5hrs (range 6-11). Average length of hospitalization 6 +/- 2 days. Estimated blood loss was

CONCLUSION

Complete complex robotic reconstruction for pediatric neurogenic bladder and bowel is feasible and safe. Further research will elicit as to whether there are tangible short or long-term benefits.

Funding: none