Pediatric Robot-Assisted Laparoscopic Varicocelectomy

Abstract

Purpose:

We determined the feasibility and safety of robot-assisted laparoscopic varicocelectomy (RALV) in the pediatric population compared with laparoscopic varicocelectomy (LV).

Patients and Methods:

We identified all patients who underwent RALV since April of 2006. For each case, we selected two age-matched controls who underwent LV and compared the groups in terms of operative times, postoperative complications, and hospital charges. Statistics were determined using the Student t test and the Fisher exact test.

Results:

Four patients underwent RALV with a mean age of 15.3 years (standard deviation 1.3). All varicoceles were left-sided. Two patients had testicular size discrepancy at presentation (mean 24%). Mean operative times were 112 minutes for RALV vs 73 minutes for LV (P = 0.02). No intraoperative or postoperative complications were experienced in the RALV group. The mean total hospital charge—including facility, equipment, anesthesiology, and recovery room fees, but excluding surgeon's professional fees—was significantly higher for the robot-assisted group ($15,800 vs $8,600, P = 0.0005).

Conclusion:

We report the first RALV in a pediatric patient population. We demonstrate that it is technically feasible with no intraoperative complications. It remains to be seen whether RALV is cost effective over LV.