Robot-Assisted Laparoscopic Urachal Excision in Children

To report the first exclusively pediatric series of robot-assisted urachal remnant excisions in children.

We reviewed the medical records of all children who underwent robot-assisted excision of urachal remnants from 2010 to 2016. For the procedure, a 3-port approach was performed in all cases. Excision of the urachus was performed, along with partial cystectomy if there was clear or suspected bladder involvement. Outcomes and complications were reviewed.

Sixteen cases of robotic urachal excision were performed during the study period in patients aged 0.8-16.5 years. Complete excision was accomplished in all cases with no conversions. Partial cystectomy was performed in 11 cases, in which a urinary catheter was left for one day in all cases (no catheter was left in absence of partial cystectomy). The only complication was a bladder leak requiring open surgical repair. There were no bowel injuries or hernias. Median operative time was 107 minutes. The length of stay was 2 days with partial cystectomy and 1 day without. All patients were well at follow-up.

We report the largest known series of robot-assisted urachal remnant excisions in children, demonstrating this minimally invasive approach to be safe and effective.

Urology. 2017 Apr 18 [Epub ahead of print]

Haris Ahmed, Adam S Howe, Lori L Dyer, Ronnie G Fine, Jordan S Gitlin, Richard N Schlussel, Paul F Zelkovic, Lane S Palmer

Cohen Children's Medical Center of NY, Division of Pediatric Urology, Hofstra Northwell School of Medicine, New Hyde Park, New York, USA., Cohen Children's Medical Center of NY, Division of Pediatric Urology, Hofstra Northwell School of Medicine, New Hyde Park, New York, USA; Maria Fareri Children's Hospital of Westchester Medical Center, Division of Pediatric Urology, Valhalla, New York, USA. Electronic address: ., Maria Fareri Children's Hospital of Westchester Medical Center, Division of Pediatric Urology, Valhalla, New York, USA., Chief, Cohen Children's Medical Center of NY, Division of Pediatric Urology, Hofstra Northwell School of Medicine, New Hyde Park, New York, USA.