Monday, May 16, 2011

Early study shows comparable outcomes for robotic and traditional surgery in pediatric urological conditions

A new study published in the May edition of the Journal of Urology is the first direct comparison study between the use of minimally invasive robotic surgery for treatment of vesicouretal reflux and the traditional, open surgical method of reimplantation. The study showed no difference in surgical outcomes between the two methods, but did reveal reduced hospital stays and pain medication requirements for pediatric patients. This research, conducted by Sheikh Zayed Institute principal investigator Craig Peters, MD, with a team at the University of Virginia, provides an early indication that this relatively novel approach poses no additional risks to children than traditional methods, while offering the benefits of minimally invasive surgery—reduced recovery time and less pain—that have been well-documented in the adult population.

“The use of robotics in children is a new and exciting field,” said Dr. Peters, who is chief of Surgical Innovation, Technology and Translation in the Sheikh Zayed Institute for Pediatric Surgical Innovation and the Joseph E. Robert, Jr., Center for Surgical Care, and a pediatric urologist. “We know there is much more research to be done to better define our expectations and outcomes for pediatric robotic surgery. However, these early studies show that this approach offers tremendous potential for minimizing pain and reducing healing time for children who require surgery.”

While the study found that operating time was 12 percent longer when using robotic laparoscopy, the average length of stay following the procedure, as well as the use of pain medication, were significantly reduced for patients who had the robotic minimally invasive procedure.

Vesicoureteral reflux is a common condition in children that can put kidneys at risk for damage from infection. Most children can be managed without surgery, but when needed, the traditional open techniques require several days in the hospital, discomfort and a 3 to 4 inch scar. While there are other minimally invasive techniques, their success rates in curing reflux are less and may not last. Open surgery is the gold standard to cure reflux, and the robotic approach offers reduced post-operative morbidity with identical cure rates.

Conducting research and development into tools and methods tailored for the unique needs of the pediatric population, including the use of robotic surgery, is a primary goal of the Sheikh Zayed Institute for Pediatric Surgical Innovation. Current robotic technology is applied for children mainly in the area of urological surgical procedures, and Dr. Peters’ bioengineering research explores the possibilities of expanding robotic surgery in children to more applications.

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