Paediatric Robotic Transperitoneal Heminephroureterectomy in Complete Duplicated Systems: Early and Long-Term Outcomes.

Di Fabrizio, D.; Cundy, TP.; Najmaldin, AS.

Paediatric Robotic Transperitoneal Heminephroureterectomy in Complete Duplicated Systems: Early and Long-Term Outcomes.

All Authors

Di Fabrizio, D.

Cundy, TP.

Najmaldin, AS.

LTHT Author

Di Fabrizio, Donatella
Cundy, Thomas
Najmaldin, Azad

LTHT Department

Leeds Children's Hospital
Paediatric Surgery

Publication Date

2025

Item Type

Journal Article

Abstract

BACKGROUND: We present outcomes for paediatric robotic heminephroureterectomy from a prospective single-surgeon series. METHODS: Children who underwent this operation between July 2007 and March 2017 were reviewed from a prospective database. RESULTS: There were 32 heminephroureterectomy (28 upper, 4 lower) for ureterocele (13), reflux (7), ectopic ureter (11), ureteric atresia (1). Co-morbidities (urological anomalies, recurrent infection, previous abdominal scarring) were common. Concomitant non-robotic procedures took place in 50%. Mean console time was 101 +/- 30.2 min, hospital stay 29.5 +/- 10.3 h. There were no conversions, intraoperative complications, and no remnant moiety function loss. Excision of diseased moiety calyces was complete in 30 (94%), incomplete in 2 (6%) who subsequently developed asymptomatic small marginal cysts. Eleven (34%) had total-ureterectomy, the remaining 21 (66%) were left with a ureteric stump. Postoperatively 3 (9%) females with residual stump (2 ureterocele, 1 bladder neck ectopia) and other urological anomalies underwent surgery (stump excision + reimplant refluxing remnant moiety ureter) for recurrent infection. CONCLUSION: In children, heminephroureterectomy is well suited to a robotic approach with favourable outcomes in our experience.