Single-port robotic Mitrofanoff in a pediatric patient

摘要

Introduction Pediatric surgery began with single-incision flank surgery and has evolved to multi-port laparoscopic and robotic approaches. Recent technological ad-vances with the single-port (SP) robot have allowed for transition back to single-incision surgery.& nbsp; Methods A 14-year-old paraplegic male with T2 spinal injury presented with neurogenic bladder and increasing difficulty performing clean intermittent catheteri-zation thus the decision was made to perform the first SP robotic Mitrofanoff procedure in a pediatric patient. The SP platform has one 2.5 cm, 4-channel port, a 12 x 10 mm articulating camera, and 6 mm multi-wristed instruments.& nbsp; Discussion The SP robotic Mitrofanoff was completed success-fully without issues with space, triangulation or articulation. There is, however, loss of insufflation with use of laparoscopic instruments as the seal on the port is difficult to maintain.& nbsp; The single-port robot has been successfully uti-lized in seven patients: six underwent dismembered pyeloplasty and one underwent Mitrofanoff with a median operative time of 120 min and estimated blood loss of <25 cc. Postoperatively, no patients required opioid pain medications, and all were dis-charged in <24 h without complications.& nbsp; Conlusions Single-port robotic surgery is feasible in pediatric patients, but patient selection is key. Future development of the platform is needed to widen application to smaller patients.