Assistant port is unnecessary for robotic-assisted laparoscopic pyeloplasty in children: a comparative cohort study
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In brief
In brief
Comparative study of 47 pediatric patients demonstrates that robotic-assisted laparoscopic pyeloplasty can be performed safely without an assistant port, achieving equivalent success rates (96-100%) while providing superior cosmetic outcomes. The three-port technique using percutaneous double-J stent placement offers a viable alternative that reduces surgical incisions without compromising efficacy or safety.
Written by the GCMD Library team from the article.
Abstract
Objective
To compare the postoperative outcomes including the cosmetic results of robotic-assisted laparoscopic pyeloplasty (RALP) performed with and without assistant port in pediatric population.
Methods
47 patients with ureteropelvic junction obstruction consecutively underwent RALP were stratified as: three-port (Group 1, n = 26) and four-port (Group 2, n = 21). In Group 1, no assistant port was placed and double-J stent was introduced with the aid of an angiocatheter via the percutaneous route. In group 2, an assistant port was placed. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale(VSS), Satava, Clavien classification systems, and success rates were compared.
Results
We found similar success rates for both groups (group 1:96.2%, group 2:100%). Two groups were similar in terms of improvement in the postoperative anteroposterior diameter of the renal pelvis and parenchymal thickness. There was no difference in terms of perioperative and postoperative complication rates (group 1:19.2%, group 2:9.5%). The total PSAS was significantly lower in Group 1 (p < 0.008). No difference was observed for VSS and OSAS.
Conclusions
Using an assistant port does not improve the success or complications of RALP, while the cosmetic outcomes are inferior to three-port RALP in children. We suggest avoiding the use of assistant port during RALP in children.