Abstract:

Objective: To investigate the safety and feasibility of the domestic single-port serpentine-arm robotic surgical system for pyeloplasty in children with congenital ureteropelvic junction obstruction (UPJO). Methods: Data of UPJO patients who underwent pyeloplasty using a domestic single-port serpentine-arm robotic surgical system (Beijing Surgerii Robotics Co., Ltd.) in Beijing Children's Hospital from November 2023 to February 2024 were retrospectively collected. The patients who were not receiving surgical treatment for the first time, had hydronephrosis caused by other reasons (such as ureterovesical junction obstruction, posterior urethral valve, urinary tract stones, vesicoureteral reflux, ureterocele, etc.), had other urinary tract malformations (such as duplicated kidneys, congenital renal dysplasia, etc.), had severe atrophy of the affected kidney, severe urinary tract infection or severe renal insufficiency were excluded. All the surgeries were performed through the umbilicus and abdominal cavity, and the operation time, number of intraoperative incisions, incision size, intraoperative blood loss, and peri-operative complications were recorded. Statistical analysis was performed to compare changes in the anteroposterior pelvic diameter (APD) and renal cortical thickness before surgery and 6 months postoperatively. Results: A total of 10 patients were included (8 males and 2 females), with an average age of (10.20±3.12) years. Nine patients were on the left side and one patient was on the right side. The average height was (142.0±17.8) cm and the average weight was (37.6±17.9) kg. All the patients underwent surgery using the domestic single-port robotic surgery system, and no patient was converted to open pyeloplasty. The total operation time was (237±96) min, and the operation time on the operating table was (162.0±69.3) min. The intraoperative blood loss was 5.00 (2.25, 5.00) mL. No complications, such as bleeding, urine extravasation, fever, and poor wound healing occurred during the perioperative period. Compared with the preoperative measurements, the APD was significantly shortened postoperatively (P=0.005), and the renal cortical thickness significantly increased (P=0.011). Conclusion: The domestic single-port serpentine arm robotic surgical system is safe and feasible for UPJO pyeloplasty in children, with good surgical results, and can be promoted and applied in most domestic medical centers.

Key words: Single-port surgical robot, Robotic surgical procedures, Hydronephrosis, Pyeloplasty, Children