Laparoscopic robotic pyeloplasty safe and has similar success rates as open surgery in infants

A recent study analyzed the outcomes of minimally invasive pyeloplasty (MIP) in treating ureteropelvic junction obstruction (UPJO), the leading cause of congenital hydronephrosis in infants. UPJO, a condition where there is a blockage where the ureter meets the kidney, has conventionally been treated with open surgery, but the study published in the Journal of Pediatric Urology suggests that MIP could be a safer alternative. 

This systematic review of 13 selected studies comprising 3,494 patients, aimed to determine whether the benefits observed in MIP for adults and children over 2 years of age extended to infants aged 1 to 23 months.

The key findings of the study were:

Infants who underwent MIP experienced, on average, 1.16 fewer hospital days compared to those who had open surgery.

The analysis revealed that the MIP group had a slightly longer operative time (137.63 minutes) compared to the open surgery group (119.92 minutes). However, this was outweighed by the significant reduction in hospital stay, making MIP an attractive option for parents and caregivers.

The study finds that laparoscopic/robotic pyeloplasty is a safe technique for infants, with success rates comparable to open surgery. However, the researchers emphasize the need for further research, particularly randomized clinical trials with extended follow-up periods, to solidify these findings with robust scientific evidence.

This breakthrough in infant surgery could revolutionize the way UPJO is treated in the youngest patients. The potential for a minimally invasive approach not just reduce hospital stay but also suggest a shift towards safer and less invasive procedures for delicate infant populations.

Further validation through extended studies are required, while this research opens the door to a new era of surgical interventions for congenital kidney conditions, offering hope for both parents and healthcare providers dealing with this common and challenging issue in infants.

Reference:

Ortiz-Seller, D., Panach-Navarrete, J., Valls-González, L., & Martínez-Jabaloyas, J. M. (2023). Comparison between open and minimally invasive pyeloplasty in infants: a systematic review and meta-analysis. In Journal of Pediatric Urology. Elsevier BV. https://doi.org/10.1016/j.jpurol.2023.11.017