Initial Experience of Single-port Robotic assisted Laparoscopic Ureteroureterostomy In Infant Duplex Systems with Upper Urinary Tract

Purpose Robotic assisted laparoscopic single port surgery (R-LSPS) has attracted more and more attention as its safety and stably function, and the patients demand for less scars after surgery. Due to the limitation of operating space in infant, there is no report about R-LSPS ureteroureterostomy before. We present the experience of R-LSPS ureteroureterostomy by Da Vinci Xi in 5 infant. Methods The clinical data of 5 infants of duplex kidney with upper urinary tract treated by R-LSPS ureteroureterostomy were collected from December 2021 to December 2023. All cases were female, aged 0.8-3.2 months (mean age 1.6± 1.0 months). The body measurements, operation time, bleeding loss, complications, length of hospitalization and other indexes were recorded. Doppler ultrasound, urine routine and urine culture were regularly rechecked after operation. The follow-up time was 6-29 months. Results The operation were done with the DaVinci Xi system. We made a 2.5-3cm incision at the lower edge of the umbilicus, inserted the a Gelport™ device without use of additional ports. Median operation time was 124.4±21.8min, median hospital stay time was 7.6±2.7 days (D), median bleeding volume was 9.0±4.2 ml. One infant had urine leak, with the sufficient drainage, the drainage tube was removed on the 8th day after surgery, on postoperative follow-up there was no ureteral stenosis. There were no complications observed on follow-up. Wounds recovered well at follow-up. Conclusion R-LSPS ureteroureterostomy is safe and feasible in infant duplex systems with upper urinary tract.