Robotic-Assisted Bladder Neck Procedures for Incontinence in Pediatric Patients

Frontiers in Pediatrics

article

Patricio C. Gargollo¹  Lindsay A. White² 

[1] Division of Pediatric Urology, The Mayo Clinic and Mayo Medical School, United States;The University of Washington School of Medicine, United States

关键词: robotic surgery;    urinary incontinence;    bladder neck reconstruction;    appendicovesicostomy;    artificial urinary sphincter;    bladder neck sling;    bladder neck closure;   

DOI  :  10.3389/fped.2019.00172

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose: To review the current status of bladder neck procedures for incontinence in pediatric patients, focusing on the increasing role of robotic-assisted laparoscopic surgical techniques. Methods: A comprehensive review of the literature on open and robotic-assisted bladder neck procedures was conducted, with a focus on articles published in the last 20 years. This data was subsequently compared with published results from robotic-assisted bladder neck reconstruction series completed at our institution. Results: The principal bladder neck procedures for incontinence in pediatric patients include: Artificial Urinary Sphincter, Bladder Neck Sling, Bladder Neck Closure and Bladder Neck Reconstruction. Continence rates range from 60 to 100% with a lack of expert consensus on the preferred procedure (or combination of procedures). Robotic-assisted approaches are associated with longer operative times, especially early in the surgical experience, but demonstrate equivalent continence rates with potential benefits including: low intraoperative blood loss, improved cosmesis, and decreased intra-abdominal adhesion formation. Conclusions: Robotic-assisted procedures of the bladder neck are safe, feasible, follow the same steps and principles as those of open surgery and produce equivalent continence rates. Robotic-assisted techniques can be adapted to a variety of bladder neck procedures and safely expanded to selected patients with previous open abdominal surgery.

【 授权许可】

CC BY