Robot-assisted pyeloplasty in children using new Versius robotic platform

Background. The authors of this paper demonstrated the operational safety and feasibility of Anderson-Hynes pyeloplasty, which was performed on the first 8 patients using the new Versius robotic system. Material and methods. The study selected and included children with a diagnosis of pyeloureteral junction obstruction who underwent primary robotic pyeloplasty at the Irkutsk State Regional Children’s Clinical Hospital. This criterion was met by 8 patients. All operations were performed by transperitoneal access using the Versius robotic platform (CMR Surgical). Surgical treatment of pyeloureteral junction obstruction was performed in the manner of the Anderson-Hynes operation. In the final part of the study, perioperative data of patients, details of operations and information about complications were analyzed. Results. The median age of patients was 10.5 [7.0; 11.8]. The ratio of male and female patients was 6/2. The side of the lesion was represented by a ratio of 4/4 (50%/50%). The antero-posterior diameter of the pelvis before surgery was 29.0 mm [25.0; 38.5]. The duration of the operation was 162.5 min [148.8; 211.3] min (min—max: 105.0—230.0 min). The duration of the robot installation was 15.0 [15.0; 20.0] min (min—max: 10.0—20.0 min). Surgical interventions were not accompanied by intraoperative complications, as well as conversions to open or laparoscopic operations. The median length of stay for patients in the intensive care unit was 19.0 [16.9; 19.3]. The median length of hospital stay was 6.5 days [6.0; 7.0 days]. Ultrasound examination, performed 3 months after the operation, showed a statistically significant decrease in antero-posterior diameter of the pelvis to 8.0 [8.0; 9.3] mm (min—max: 5.0—16.0 mm). All patients demonstrated the absence of early (urinoma) and late (relapse, loss of kidney function) complications. Conclusion. This study was the first clinical trial to investigate the efficacy and safety of the Versius system in pyeloplasty in children with pyeloureteral junction obstruction. Early preclinical and clinical results have confirmed the potential benefit of this system when performing minimally invasive procedures in children with obstructive kidney disease.