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Assistant port is unnecessary for robotic-assisted laparoscopic pyeloplasty in children: a comparative cohort study

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Abstract

Objective

To compare the postoperative outcomes including the cosmetic results of robotic-assisted laparoscopic pyeloplasty (RALP) performed with and without assistant port in pediatric population.

Methods

47 patients with ureteropelvic junction obstruction consecutively underwent RALP were stratified as: three-port (Group 1, n = 26) and four-port (Group 2, n = 21). In Group 1, no assistant port was placed and double-J stent was introduced with the aid of an angiocatheter via the percutaneous route. In group 2, an assistant port was placed. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale(VSS), Satava, Clavien classification systems, and success rates were compared.

Results

We found similar success rates for both groups (group 1:96.2%, group 2:100%). Two groups were similar in terms of improvement in the postoperative anteroposterior diameter of the renal pelvis and parenchymal thickness. There was no difference in terms of perioperative and postoperative complication rates (group 1:19.2%, group 2:9.5%). The total PSAS was significantly lower in Group 1 (p < 0.008). No difference was observed for VSS and OSAS.

Conclusions

Using an assistant port does not improve the success or complications of RALP, while the cosmetic outcomes are inferior to three-port RALP in children. We suggest avoiding the use of assistant port during RALP in children.

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Authors and Affiliations

  1. Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Yavuz Onur Danacioglu

  2. Department of Urology, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey

    Ferhat Keser

  3. Department of Urology, Amasya University, Amasya, Turkey

    Salih Polat

  4. Department of Urology, Nigde Omer Halisdemir University, Nigde, Turkey

    Bilal Gunaydin

  5. Department of Urology, Uskudar University, Istanbul, Turkey

    Yusuf Ilker Comez

  6. Department of Urology, Biruni University, Istanbul, Turkey

    Mesrur Selcuk Silay

Authors
  1. Yavuz Onur Danacioglu
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  2. Ferhat Keser
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  3. Salih Polat
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  4. Bilal Gunaydin
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  5. Yusuf Ilker Comez
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  6. Mesrur Selcuk Silay
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Contributions

YOD: protocol development, data collection, and manuscript writing. FK: data collection and manuscript writing. SP: data analysis. BG: data management. YIC: data collection or management. MSS: protocol development, data management, and manuscript writing.

Corresponding author

Correspondence to Mesrur Selcuk Silay.

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Competing interests

The authors declare no competing interests.

Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Research involving human participants

The study was approved by the ethical committee of Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital (2021/100). The study was performed in accordance with the ethical standards of 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all individual participants and from their parents included in the study.

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Danacioglu, Y.O., Keser, F., Polat, S. et al. Assistant port is unnecessary for robotic-assisted laparoscopic pyeloplasty in children: a comparative cohort study. Pediatr Surg Int 38, 1327–1334 (2022). https://doi.org/10.1007/s00383-022-05158-3

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  • DOI: https://doi.org/10.1007/s00383-022-05158-3

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