Our Summary

This research paper reviews the use of robotic-assisted surgeries for kids with a condition called vesicoureteral reflux (VUR), where urine flows backward from the bladder into the kidneys. The specific procedure discussed is the laparoscopic ureteral reimplantation, a less invasive surgery that can be performed with the help of a robot. However, the paper acknowledges that the use of this new technology has led to some unexpected complications and mix results in different hospitals. This variability might be due to the learning curve that comes with any new technology or procedures. As of now, the traditional open surgery remains the preferred method for treating VUR. The paper concludes that while the robot-assisted surgery is a promising less invasive option, there is still a need for more experience and practice to ensure high success rates and fewer complications.

FAQs

  1. What is vesicoureteral reflux (VUR) and how is it treated?
  2. What is laparoscopic ureteral reimplantation and how is it performed?
  3. What are the potential complications and benefits of robotic-assisted surgeries for VUR?

Doctor’s Tip

A doctor might tell a patient undergoing ureteral reimplantation to follow all post-operative instructions carefully, including taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments. It is important to communicate any unusual symptoms or concerns to your healthcare provider promptly. Additionally, staying hydrated and maintaining a healthy lifestyle can help support healing and recovery after surgery.

Suitable For

Patients who are typically recommended ureteral reimplantation include those with vesicoureteral reflux (VUR) that is causing recurrent urinary tract infections, kidney damage, or other complications. This condition is more common in children, especially those with a family history of VUR or other urinary tract abnormalities. Ureteral reimplantation may also be recommended for adults with severe VUR that is not responding to other treatments.

Timeline

Before ureteral reimplantation:

  • Patient is diagnosed with vesicoureteral reflux (VUR) through imaging tests and symptoms such as frequent urinary tract infections.
  • Treatment options are discussed with the patient and their family, including the possibility of ureteral reimplantation.
  • Pre-operative tests and evaluations are conducted to ensure the patient is a suitable candidate for surgery.

During ureteral reimplantation:

  • Patient undergoes anesthesia and the surgeon makes small incisions in the abdomen to access the ureters.
  • The ureters are detached from the bladder and repositioned to prevent urine from flowing back into the kidneys.
  • The surgery is performed using a robot-assisted laparoscopic technique, allowing for greater precision and less tissue damage.
  • The procedure typically takes a few hours to complete.

After ureteral reimplantation:

  • Patient is monitored closely in the recovery room for any immediate complications.
  • Pain management and antibiotics are prescribed to prevent infection and manage discomfort.
  • Patient may stay in the hospital for a few days for observation before being discharged.
  • Follow-up appointments are scheduled to monitor the success of the surgery and ensure proper healing.
  • Long-term care may include routine check-ups and monitoring for any signs of VUR recurrence.

What to Ask Your Doctor

  1. What are the benefits of robotic-assisted laparoscopic ureteral reimplantation compared to traditional open surgery?
  2. What are the potential risks and complications associated with robotic-assisted laparoscopic ureteral reimplantation?
  3. How experienced is the surgical team in performing robotic-assisted ureteral reimplantation procedures?
  4. What is the success rate of robotic-assisted ureteral reimplantation in treating vesicoureteral reflux?
  5. How long is the recovery time expected to be for robotic-assisted ureteral reimplantation compared to traditional open surgery?
  6. Are there any specific pre-operative or post-operative instructions that I should follow for a successful outcome with robotic-assisted ureteral reimplantation?
  7. What is the follow-up care plan after undergoing robotic-assisted ureteral reimplantation surgery?
  8. Are there any limitations or contraindications to consider for robotic-assisted ureteral reimplantation in my specific case?
  9. How does the cost of robotic-assisted ureteral reimplantation compare to traditional open surgery, and will my insurance cover the procedure?
  10. Are there any ongoing clinical trials or research studies investigating the effectiveness of robotic-assisted ureteral reimplantation for vesicoureteral reflux?

Reference

Authors: Gerber JA, Koh CJ. Journal: World J Urol. 2020 Aug;38(8):1849-1854. doi: 10.1007/s00345-019-02766-y. Epub 2019 Apr 19. PMID: 31004205