Abstract
Clinical History:
A 1-year-old boy weighted 3200 g at birth through cesarean section at 41 weeks and had antenatal hydronephrosis in his left pelvic ectopic kidney. An ectopic pelvic kidney is one example of a complicated renal abnormality that may coexist with a ureteropelvic junction obstruction. 1 Robot-assisted laparoscopic pyeloplasty, as we demonstrate in this video, is one of the safest techniques for reconstructive surgery of this intricate anomaly.
Physical Examination:
Physical examination revealed severe chordee and coronal hypospadias.
Diagnosis:
Urinary ultrasonography and magnetic resonance imaging urography revealed that left kidney is located in the pelvic area and is hydronephrotic (anteroposterior diameter of the renal pelvis was ∼16 mm). Technetium-99m MAG3 (mercaptuacetyltriglycine) scintigraphy revealed the split function of the left kidney is 35%, obstructive drainage pattern.
Intervention:
Based on European Pediatric Urology guidelines, 2 surgery was offered to the family as the recommended course of action. Da Vinci XI robotic system was used for Anderson Hynes's pyeloplasty. The duration of surgery was 140 minutes.
Follow-Up/Outcomes:
Urethral catheter was removed on day 1, drain was removed on day 2. The length of hospital stay was 3 days. The postoperative first-month estimated glomerular filtration rate was calculated as 164 mL/(min⸱1.73 m 2 ) using the Schwartz formula. On first month follow-up ultrasound examinations, renal pelvis diameter decreased and parenchymal thickness remained stable. No fascia or skin-related problems were detected at the trocar insertion sites. Reconstructive surgery of complex renal anomalies can be performed safely with the three-dimensional imaging and magnification of robot-assisted laparoscopic methods.
This video publication received written informed consent for publication of the specific patient's case and was obtained from both parents. Authors have received and archived patient consent for video recording/publication in advance of the video recording of the procedure
.
No competing financial interests exist.
No funding was received for this article
.
Runtime of video: 3 mins 34 secs
Get full access to this article
View all access options for this article.