The Application of Robotic-Assisted Surgery in Renal Disorders of Infants and Toddlers: A Retrospective Cohort Analysis

<b><i>Objective:</i></b> While robotic-assisted surgery (RAS) has shown benefits in urology, its use in infants and toddlers remains relatively restricted. This study aims to evaluate the safety and feasibility of robotic surgery for renal disorders in this age group. <b><i>Methods:</i></b> A retrospective analysis was performed on the clinical data of 122 patients under the age of 3 who underwent robotic and laparoscopic surgeries (LSs) for renal disorders at our institution between December 2021 and September 2023. The analysis included demographic information, surgical techniques, and postoperative complications. <b><i>Results:</i></b> The study included 122 patients aged between 2.2 and 35.8 months. Of these, 66 patients underwent RAS (RAS group), whereas 56 patients underwent laparoscopic surgery (LS group). In cases of ureteropelvic junction obstruction (UPJO), RAS group showed shorter operative times and less blood loss than LS (<i>P</i> < .001). For the patients with renal dysplasia who underwent nephrectomy and ureterectomy, no significant differences were observed between the RAS and LS groups in terms of operative time, intraoperative blood loss, or hospital stay (<i>P</i> > .05). In patients with duplicated kidneys, RAS also demonstrated advantages in operative time (<i>P</i> = .001), blood loss (<i>P</i> = .019), and hospital stays (<i>P</i> < .001). However, RAS group incurred higher hospital costs (<i>P</i> < .001), with no significant difference in complication rates (<i>P</i> > .05). <b><i>Conclusion:</i></b> Although RAS incurs higher costs compared with LS, it remains both safe and feasible for the treatment of renal disorders in infants and toddlers. Notably, RAS shows significant advantages in managing UPJO and complete duplicated kidneys.