Current Indications for Robotic Surgery in Pediatric Urology

Purpose of review: Over the last decade, the use of the robotic surgical system has significantly increased in the pediatric population and new indications for the robot are being developed. We aim to explore the current indications for robotic urologic surgery in children. Recent findings: Robotic surgeries in urology has been found to have similar outcomes to equivalent open surgeries while also providing decreased post-operative length of hospitalization and post-operative narcotic usage. Recent results suggest that robotic incisions do not grow significantly as patients grow and may have better cosmetic outcomes in the long term. Robotic pyeloplasty and extravesical ureteral reimplantation have shown to have excellent results, including in complicated and re-operative cases. Urologic reconstruction techniques are described using the robotic surgical system as well with promising early results though techniques are still developing. Overall, robotic surgery is generally more expensive than open surgery. Summary: Robotic surgery in urology has many indications, including pyeloplasty, ureteral reimplantation, nephrectomy or partial nephrectomy, oncology, and reconstruction for neurogenic bowel and bladder. The use of the robotic system is safe and effective for these procedures with similar outcomes and operative metrics to open surgeries while conferring the advantage of decreased length of post-operative hospitalization and decreased post-operative narcotic usage.