Robot-assisted laparoscopic single-port pyeloplasty using the da Vinci SP® system: initial experience with a pediatric patient

Introduction: The da Vinci SP® Robotic Surgical Platform (Intuitive Surgical) was recently introduced to overcome triangulation and motion restriction during laparoendoscopic single-site surgery. The authors describe a pure, single-site, robot-assisted, laparoscopic pyeloplasty (RALP) using the da Vinci SP System in a pediatric patient. Material and methods: A 10-year-old patient with ureteropelvic junction obstruction underwent pyeloplasty conducted using the da Vinci SP® System. Retrospective perioperative and immediate postoperative outcomes were investigated. Results: Surgery was completed with pure single-site surgery without additional port placement or standard multiport conversion. The total operation time was 211 min, and the console time was 90 min. The docking time was much greater than that of previous pyeloplasty operations using multiport system. This result may be because of difficulties caused by bulky instrumentation entering the pneumoperitoneum. The estimated blood loss was minor, and there were no intraoperative or perioperative complications. Ureteral stent was removed after 4 weeks. Cosmetic outcomes were satisfactory. Conclusions: Pure, single-site RALP using da Vinci SP® System seems feasible in aging children. Additional studies involving more patients, younger children, and long-term outcomes are required.