Category: Laparoscopic/ Robotic: Renal

VS6-8 - Robotic Right Simple Nephrectomy for Non-Functional Kidney in a Pediatric Patient: Techniques For an Adult Minimally Invasive Surgeon

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : The skillset of the adult robotic surgeon continues to grow and expand with experience. Pediatric Urologists perform a greater amount of open procedures and those unfamiliar with minimally invasive techniques may seek out the assistance of an adult robotic surgeon. As adult minimally surgeons, we have collaborated on over 50 cases with our pediatric colleagues to provide care for their patients with a robotic approach ranging from pyeloplasty to partial/radical nephrectomy for a variety of etiologies including non-functional moiety, renal tumors, and ureteral reimplantation/tapering.


Methods : We demonstrate a robotic right simple nephrectomy in an 11-year-old female patient who has a history of failed pyeloplasty. The patient now has a non-functional kidney 19x13cm in size with severe hydronephrosis that is crossing the midline. Renal Scan shows 3% function. We demonstrate the approach performed by a high-volume adult robotic surgeon.


Results :

Our patient tolerated the procedure well. Her post-operative course was non-complicated. Her pain was controlled, she tolerated a clear liquid diet, and was discharged home on post-operative day one. Our operative time was under forty-five minutes.


Conclusions :

It is not uncommon to be approached by our pediatric colleagues for assistance in a case where the patient will be best served by a minimally invasive approach. Our group has collaborated on various surgeries to work with our pediatric colleagues and provide quality minimally invasive urological care. High volume robotic surgeons are able to provide good outcomes and decreased operative time. Consideration to the anatomy and modification of traditional techniques is required to diligently perform these cases.

Neel Patel

Resident
New York Medical College
Valhalla, New York

Feng Guo

New York Medical College
Valhalla, New York

Nikhil Gopal

New York Medical College
Valhalla, New York

Gregory Lovallo

Attending Urologist
Hackensack University Medical Center
Maywood, New Jersey

Christopher Wright

Hackensack, New Jersey

Terry Hensle

Hackensack, New Jersey

Mutahar Ahmed

Attending Urologist
Hackensack University Medical Center
Maywood, New York

Mutahar Ahmed MD FACS
Director of the Center for Bladder Cancer and Reconstructive Urologic Surgery at Hackensack University Medical Center, in Hackensack, NJ
Clinical Assitant Professor Hackensack Meridian Seton Hall School of Medicine
Clinical Assistant Professor Rutgers University School of Medicine