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The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center

BACKGROUND: Robotic-assisted pyeloplasty surgery has become the preferred approach of ureteropelvic junction obstruction (UPJO) in pediatrics. However, to our knowledge, there is limited data on the learning curve for robotic-assisted pyeloplasty in children and no similar study from Saudi Arabia. A...

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Autores principales: Junejo, Noor Nabi, Alotaibi, Anwar, Alshahrani, Saeed Malwi, Alshammari, Ahmad, Peters, Craig A., Alhazmi, Hamdan, Vallasciani, Santiago A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978967/
https://www.ncbi.nlm.nih.gov/pubmed/32015612
http://dx.doi.org/10.4103/UA.UA_113_19
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author Junejo, Noor Nabi
Alotaibi, Anwar
Alshahrani, Saeed Malwi
Alshammari, Ahmad
Peters, Craig A.
Alhazmi, Hamdan
Vallasciani, Santiago A.
author_facet Junejo, Noor Nabi
Alotaibi, Anwar
Alshahrani, Saeed Malwi
Alshammari, Ahmad
Peters, Craig A.
Alhazmi, Hamdan
Vallasciani, Santiago A.
author_sort Junejo, Noor Nabi
collection PubMed
description BACKGROUND: Robotic-assisted pyeloplasty surgery has become the preferred approach of ureteropelvic junction obstruction (UPJO) in pediatrics. However, to our knowledge, there is limited data on the learning curve for robotic-assisted pyeloplasty in children and no similar study from Saudi Arabia. AIMS: The objective of the study was to evaluate the progression of the surgical team performing robotic-assisted laparoscopic pyeloplasty (RALP) and to assess the feasibility of the RALP in children, since it is having been recently started in the Kingdom. SETTINGS AND DESIGN: Retrospective charts and surgical videos review at the tertiary care centre. SUBJECTS AND METHODS: After approval from the internal review board (IRB), we reviewed the surgical video recording of the RALP procedure of 15 patients presented with UPJO from January 2016 to October 2017. Statistical analysis was done for the variables includes dissection time, pyelotomy, anastomosis on both sides, and total surgery time and calculated in minutes. Renal ultrasound reviewed to assess any change in grade. RESULTS: Fifteen patients with UPJO underwent RALP. Of 15 cases, nine were primary and six cases as secondary UPJO. The median age was 8 (3–15) years. Out of 15 cases, 13 and 2 patients diagnosed as Society for Fetal Urology grades of 4 and 3, respectively. Total operative time was prolonged in secondary group as compared to primary pyeloplasty group (mean [standard deviation (SD)]: 166.3 [35.1], range: 125–223, P = 0.0028 versus mean (SD): 149.17 (30.4), range: (114–207), P = 0.0008). The success rate was 100% in primary and 84% in secondary cases. The median length of follow-up was 12.0 (7.0–18.0) and 10.0 (8.0–12.5) months in primary and secondary cases, respectively. The overall complication rate was 13% (2/15) (Clavien grade: 1–2). CONCLUSIONS: The evaluation of the learning curve of RALP for this group of patients concluded that total operative time for RALP, performed by the pediatric urology team, steadily decreased with collective surgical experience.
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spelling pubmed-69789672020-02-03 The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center Junejo, Noor Nabi Alotaibi, Anwar Alshahrani, Saeed Malwi Alshammari, Ahmad Peters, Craig A. Alhazmi, Hamdan Vallasciani, Santiago A. Urol Ann Original Article BACKGROUND: Robotic-assisted pyeloplasty surgery has become the preferred approach of ureteropelvic junction obstruction (UPJO) in pediatrics. However, to our knowledge, there is limited data on the learning curve for robotic-assisted pyeloplasty in children and no similar study from Saudi Arabia. AIMS: The objective of the study was to evaluate the progression of the surgical team performing robotic-assisted laparoscopic pyeloplasty (RALP) and to assess the feasibility of the RALP in children, since it is having been recently started in the Kingdom. SETTINGS AND DESIGN: Retrospective charts and surgical videos review at the tertiary care centre. SUBJECTS AND METHODS: After approval from the internal review board (IRB), we reviewed the surgical video recording of the RALP procedure of 15 patients presented with UPJO from January 2016 to October 2017. Statistical analysis was done for the variables includes dissection time, pyelotomy, anastomosis on both sides, and total surgery time and calculated in minutes. Renal ultrasound reviewed to assess any change in grade. RESULTS: Fifteen patients with UPJO underwent RALP. Of 15 cases, nine were primary and six cases as secondary UPJO. The median age was 8 (3–15) years. Out of 15 cases, 13 and 2 patients diagnosed as Society for Fetal Urology grades of 4 and 3, respectively. Total operative time was prolonged in secondary group as compared to primary pyeloplasty group (mean [standard deviation (SD)]: 166.3 [35.1], range: 125–223, P = 0.0028 versus mean (SD): 149.17 (30.4), range: (114–207), P = 0.0008). The success rate was 100% in primary and 84% in secondary cases. The median length of follow-up was 12.0 (7.0–18.0) and 10.0 (8.0–12.5) months in primary and secondary cases, respectively. The overall complication rate was 13% (2/15) (Clavien grade: 1–2). CONCLUSIONS: The evaluation of the learning curve of RALP for this group of patients concluded that total operative time for RALP, performed by the pediatric urology team, steadily decreased with collective surgical experience. Wolters Kluwer - Medknow 2020 2019-12-23 /pmc/articles/PMC6978967/ /pubmed/32015612 http://dx.doi.org/10.4103/UA.UA_113_19 Text en Copyright: © 2019 Urology Annals http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Junejo, Noor Nabi
Alotaibi, Anwar
Alshahrani, Saeed Malwi
Alshammari, Ahmad
Peters, Craig A.
Alhazmi, Hamdan
Vallasciani, Santiago A.
The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center
title The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center
title_full The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center
title_fullStr The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center
title_full_unstemmed The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center
title_short The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center
title_sort learning curve for robotic-assisted pyeloplasty in children: our initial experience from a single center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978967/
https://www.ncbi.nlm.nih.gov/pubmed/32015612
http://dx.doi.org/10.4103/UA.UA_113_19
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