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VR-25
(VS)
ROBOT-ASSISTED LAPAROSCOPIC LOWER POLE PARTIAL NEPHRECTOMY IN THE
PEDIATRIC POPULATION
Patricia CHO
1
, Ashley WIETSMA
2
, Michael HOLLIS
1
and Richard YU
1
1) Boston Children's Hospital, Harvard Medical School, Urology, Boston, USA - 2) Boston Children's Hospital, Urology,
02115, USA
INTRODUCTION
In pediatric urology, partial nephrectomy is used primarily to remove a nonfunctioning renal moiety, more commonly
the upper pole, in a duplicated system. The most common causes of decreased function are reflux, obstruction from an
ureterocele, and ectopic ureters. Although our institution has previously reported our experience with older, larger
children (median age 7.2 years, median weight 34.8 kg), there is limited data involving infants. As such, we present a
video of a robot-assisted laparoscopic lower pole partial nephrectomy in an infant.
METHODS
Our patient was an 11 month old (10.7kg) male with a history of prenatal hydronephrosis, who was diagnosed
postnatally with a duplicated right collecting system. Ultrasonography revealed severe hydroureteronephrosis of the
right lower collecting system. Voiding cystourethrogram showed reflux into the right lower pole with concomitant
evidence of ureteropelvic junction obstruction. A DMSA demonstrated a differential renal function with 68% in the left
kidney and 32% in the right kidney, but no radiotracer uptake in the right lower pole. A robot-assisted laparoscopic
lower pole partial nephrectomy was performed.
RESULTS
There were no intraoperative or postoperative complications. On postoperative day one, the urethral Foley catheter was
removed, and the patient was discharged home. At one-month postoperatively, an ultrasound demonstrated no
hydronephrosis or perinephric fluid collection.
CONCLUSIONS
Robotic partial nephrectomy is safe and feasible in pediatrics including both older children and infants. It is successful
for both upper and lower pole partial nephrectomies.