Pediatric Minimally Invasive Pyeloplasty

Ureteropelvic junction obstruction (UPJO) is a common urologic abnormality in children. The diagnosis is typically based on a combination of clinical symptoms, ultrasonographic findings of hydronephrosis without hydroureter, and sometimes diuretic renal scintigraphy. Acceptance of robotic technology is increasing among pediatric urologists, and robotic pyeloplasty is now commonly performed for children with UPJO, with success rates similar to open pyeloplasty and a more efficient learning curve than conventional laparoscopy. The Anderson-Hynes dismembered pyeloplasty is the standard approach for repair. When complex patient anatomy is encountered, alternative techniques can be used to tailor the procedure to the specific case. Overall, robotic pyeloplasty offers strong outcomes, low complication rates, and a minimal rate of conversion to open surgery. Although the initial cost of robotic technology may be high, human capital gain and indirect benefits from shortened hospitalizations, smaller incisions, and parental satisfaction may be valuable.  This review contains 10 figures, 5 tables and 42 references Key words: Pediatrics, Minimally invasive surgery, Robotics, Ureteropelvic junction obstruction, Pyeloplasty, Urology