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| Name | Robotic Vesicoscopic Cohen’s reimplantation for pediatric vesicoureteric reflux |
| Video Uploader | Video From Vattikuti Foundation |
| Upload Date | This Video Uploaded At 19-11-2019 16:26:45 |
| Video Discription | 2019 KS National Robotic Surgery Awards 1st Place Winner as selected at the Robotic Surgeons Council of India. From the Abstract: Robotic Vesicoscopic Cohen’s reimplantation for pediatric vesicoureteric reflux Authors: Dr Ravi P Kanojia, Dr Monika Bawa Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India Aim: Vesicoscopic reimplantation (VR) entails placing the access ports inside the bladder and inflating with CO2 to create pneumo-vesicum. The space thus created makes it possible to perform reconstructive procedures entirely within the bladder. Port placement and the reconstructive procedures are technically challenging in pediatric age group. We aim to demonstrate the surgical procedure of Robotic Vesicoscopic reimplantation (RVR), showing the technical aspects of the procedure. The procedure also shows how the robotic instruments make this procedure much easier to accomplish the reconstructive target of reimplantation compared to the same procedure being done laparoscopically. Patients and Method: a 4-yr. old girl presented with right grade-IV Vesico-ureteric reflux (VUR). She underwent RVR with DaVinci Si system. Ports used were 8mm 300 camera port with two 5mm working ports and no assistant port. The video demonstrates how the ports are placed in the bladder to achieve pneumo-vesicum and docking of the patient cart. The ureter was re-implanted with Cohen’s method.The 2nd patient was 2 years and had dilated ureter for which ureteral tapering was done before reimplanting. The video demonstrates the ease of creating the submucosal tunnel and doing uretero-neocystostomy. The instruments used were Maryland dissectors, scissors, and needle driver. Suction was done via a urethral catheter. Result: The console time was 45 min & 90 min with 20 min port placement and docking time. The patient resumed orals on same day and was discharged after 24 hours of observation. The same procedure if done open requires approx. 4-5 days of hospitalization. The follow up is now 6 months. There is reflux resolution in follow up VCUG. Conclusion: Use of robotic approach for VR makes the technically challenging procedure of vesicoscopy easy for the surgeon. The wristed instruments make the reconstruction faster and easy. A certain degree of learning curve is needed which can be overcome if there is previous experience with non-robotic vesicoscopic reimplantation. Robotic surgery video, with PPT's, X-ray, photos, narrated, 08:00 min. See more at: http://vfrsi.vattikutifoundation.com/ |
| Category | Science & Technology |
| Tags | Robotic Surgery | Pediatric Urology | Vesico-ureteric reflux | Robotic Vesicoscopic reimplantation | Dr. Ravi P. Kanojia | Dr. Monika Bawa | Robotic Surgeons Council of India | Vattikuti Foundation |
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