COMPARISON OF OPEN AND ROBOTIC ASSISTED LAPAROSCOPIC URETERIC RE-IMPLANTATION PROCEDURES IN PATIENTS WITH VESICOURETERAL REFLUX: NARRATIVE LITERATURE REVIEW

Vesicoureteral reflux (VUR) is a prevalent congenital urological disorder that can lead to recurrent urinary tract infections and renal scarring. Surgical intervention, particularly ureteric reimplantation, is often necessary to prevent these complications, with open surgery being the traditional approach. However, advancements in surgical techniques have introduced robotic-assisted laparoscopic ureteric reimplantation as an alternative. This literature review compares the outcomes, benefits, and limitations of open versus robotic-assisted ureteric reimplantation in treating VUR. The evolution of surgical management for VUR has been marked by continuous refinement, from early open surgical techniques to the introduction of laparoscopic and robotic-assisted procedures. While open ureteric reimplantation remains a gold standard with high success rates (ranging from 80.7% to 99.1%), robotic-assisted techniques have gained popularity due to their minimally invasive nature, which leads to shorter recovery times, reduced postoperative pain, and better cosmetic results, especially in pediatric patients. However, the robotic approach is not without challenges, including longer operative times, higher costs, and the necessity for specialized training. Both surgical methods have distinct complication profiles, with open surgery being more prone to wound-related complications and robotic surgery associated with risks like urinary retention and ureteral injury due to the lack of haptic feedback. The choice between these approaches should be individualized, considering the patients specific needs, the surgeons expertise, and resource availability. Additionally, long-term follow-up is crucial for monitoring recurrent UTIs, renal scarring, and other potential complications. The review concludes that while both techniques are effective, the decision should be guided by a comprehensive assessment of the patients condition and the surgeons proficiency with the respective technique.