TY - JOUR
T1 - Current status of robotic-assisted surgery for the treatment of vesicoureteral reflux in children
AU - Timberlake, Matthew D.
AU - Peters, Craig A
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Purpose of review: Although open ureteral reimplantation remains the gold standard for surgical correction of vesicoureteral reflux (VUR), robotic-assisted laparoscopic ureteral reimplantation (RALUR) holds promise and is becoming more widely utilized. The present article outlines primary operative techniques for RALUR, summarizes the current literature with respect to surgical outcomes and costs, and discusses early applications of RALUR to complex and reoperative cases. Recent findings: Intravesical and extravesical techniques for RALUR have been described. Published outcomes vary with respect to operational definitions of surgical success and reporting of complications. Several studies have directly compared RALUR and open reimplant, suggesting equivalent efficacy and safety. Recent noncomparative studies have reported lower VUR resolution rates and higher complication rates for RALUR, particularly in bilateral cases. The application of RALUR to reoperative surgery and cases requiring tapering and dismemberment is under very early investigation. RALUR is consistently associated with lower postoperative analgesic requirements and decreased hospital stay, but longer operative times and higher costs compared to open reimplant. Summary: Published outcomes after RALUR show mixed results that, on average, may be inferior to open reimplant. Future investigations should seek to identify patient-related and intraoperative factors associated with successful and unsuccessful outcomes.
AB - Purpose of review: Although open ureteral reimplantation remains the gold standard for surgical correction of vesicoureteral reflux (VUR), robotic-assisted laparoscopic ureteral reimplantation (RALUR) holds promise and is becoming more widely utilized. The present article outlines primary operative techniques for RALUR, summarizes the current literature with respect to surgical outcomes and costs, and discusses early applications of RALUR to complex and reoperative cases. Recent findings: Intravesical and extravesical techniques for RALUR have been described. Published outcomes vary with respect to operational definitions of surgical success and reporting of complications. Several studies have directly compared RALUR and open reimplant, suggesting equivalent efficacy and safety. Recent noncomparative studies have reported lower VUR resolution rates and higher complication rates for RALUR, particularly in bilateral cases. The application of RALUR to reoperative surgery and cases requiring tapering and dismemberment is under very early investigation. RALUR is consistently associated with lower postoperative analgesic requirements and decreased hospital stay, but longer operative times and higher costs compared to open reimplant. Summary: Published outcomes after RALUR show mixed results that, on average, may be inferior to open reimplant. Future investigations should seek to identify patient-related and intraoperative factors associated with successful and unsuccessful outcomes.
KW - Pediatrics
KW - Reimplantation
KW - Robotic surgery
KW - Ureteroneocystostomy
KW - Urologic surgical procedures
KW - Urology
KW - Vesicoureteral reflux
UR - http://www.scopus.com/inward/record.url?scp=84992052347&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992052347&partnerID=8YFLogxK
U2 - 10.1097/MOU.0000000000000357
DO - 10.1097/MOU.0000000000000357
M3 - Review article
C2 - 27764016
AN - SCOPUS:84992052347
SN - 0963-0643
VL - 27
SP - 20
EP - 26
JO - Current opinion in urology
JF - Current opinion in urology
IS - 1
ER -