Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S28-10

(P)

ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY IN DUPLICATED COLLECTING

SYSTEM FOR CHILDREN BELOW THAN 15 KG.

Quentin BALLOUHEY

, Thierry VILLEMAGNE

, Pauline CLERMIDI

, Caroline SZWARC

, Karim BRAIK

, Hubert LARDY

and

Laurent FOURCADE

1) Limoges University Hospital, Pediatric Surgery, Limoges, FRANCE - 2) Tours university Hospital, Pediatric Surgery,

Tours, FRANCE

PURPOSE

Laparoscopic transperitoneal approach for heminephrectomy (HN) has been reported as a safe technique with a low

conversion rate for children. The aim of our study was to report the outcomes of robotic-assisted HN for duplex kidney

in children below 15 kg.

MATERIAL AND METHODS

This prospective multicentric study evaluated the HN performed from 2007 to 2014. Demographic data, weight, surgical

time, hospital stay, complications were collected. Mean follow-up was 26 months (5-58), based on clinical data, renal

sonography and isotopic renogram.

RESULTS

Fifteen patients weighing less than15 kg underwent PN. All of them had prenatal diagnosis of duplicated system. Mean

age at surgery was 20.2 (7-39) months with a policy of early surgical intervention in cases of massively dilated upper

renal tract. There was no conversion to open and mean total operative time was 201 min (130-245). All procedures

started with a cystoscopic evaluation as this allows catheterization of the preserved ureter before transperitoneal

approach with four laparoscopic ports. Mean hospital length of stay was 3.4 days (1-7) and 1,2 days for our 6 last

patients. One patient had an omentum hernia that required a second operation. At initial follow-up ultrasound 1 patient

(6%) demonstrated an asymptomatic fluid collection and was managed conservatively. No patients lost their remaining

healthy moiety.

CONCLUSIONS

Compared to previously published literature evaluating open and laparoscopic heminephrectomy in small children,

robotic system provides comparable outcomes in regards to feasability and complication rate. The safety of the

dissection seems to allow shorter hospital length of stay.