Robot-assisted intravesical ureteral reimplantation in a 13-year-old adolescent: A case report

The efficacy and safety of intravesical ureteral reimplantation in children have been demonstrated in an extensive clinical data, widely reported in the literature over the past two decades. However, its widespread adoption remains limited due to significant technological challenges, primarily the need to operate within an extremely confined space inside the bladder and the non-ergonomic positioning required for the surgeon. Robotic-assisted surgery may help overcome these limitations by improving both the learning curve and surgical ergonomics. This article presents our first experience with robot-assisted intravesical ureteral reimplantation using the da Vinci Xi system in a 13-year-old girl with vesicoureteral reflux and recurrent urinary tract infections. A Cohen ureteroneocystostomy was successfully completed without conversion and with no intraoperative complications. The total operative time was 160 minutes, with 85 of console time. Estimated blood loss was 10 mL. In the postoperative period, a single complication was observed—a urinary tract infection, which was successfully managed conservatively. Our experience demonstrates that robot-assisted intravesical ureteral reimplantation is a feasible and minimally invasive alternative to both laparoscopic and conventional intravesical ureteroneocystostomy, providing a higher level of surgical comfort. However, further studies are needed to assess the feasibility and outcomes of intravesical da Vinci Xi surgery in younger pediatric patients.