Limits...
Robotic augmentation ileocystoplasty with bilateral ureteric reimplantation in a young child with neuropathic bladder.

Chowdhary SK, Kandpal DK, Agarwal D, Sibal A, Srivastava RN - J Indian Assoc Pediatr Surg (2014)

Bottom Line: The management starts early in life.The open surgery has proven safety and success over many decades.The emergence of robotic technology has revived the interest in minimally invasive approach for complex pediatric urological reconstructions.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Urology and Pediatric Surgery, Indraprastha Apollo Hospitals, New Delhi, India.

ABSTRACT
Neuropathic bladder in children is most commonly secondary to spina bifida. The management starts early in life. The modalities of treatment vary depending on the severity of the symptoms. A proportion of children inspite of adequate medical management need augmentation ileocystoplasty later in life. The open surgery has proven safety and success over many decades. Earlier attempts to perform augmentation cystoplasty by the laparoscopic approach were limited by steep learning curve, long operating times, and technical difficulties in intracorporeal anastomosis. The emergence of robotic technology has revived the interest in minimally invasive approach for complex pediatric urological reconstructions. In the recent times, there has been only one reported case report and small series of pediatric robotic augmentation cystoplasty from Chicago. We report the first minimally invasive robotic reconstruction in a child with neuropathic bladder and early renal decompensation despite appropriate medical treatment, from our country.

No MeSH data available.


Related in: MedlinePlus

Postoperative cystometry showing functional bladder capacity of 100 ml with detrusor pressure in physiological limits
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4155634&req=5

Figure 2: Postoperative cystometry showing functional bladder capacity of 100 ml with detrusor pressure in physiological limits

Mentions: In the postoperative period morphine infusion was given for pain relief for 48 hours. The abdominal drain was removed on third postoperative day. Oral feedings were started on fifth postoperative day. A check Cystogram was done at 2 weeks which revealed no vesicoureteric reflux and a bladder capacity of 100 ml. The suprapubic drain and DJ stents were removed. The urethral catheter was removed and child was started on intermittent clean catheterization per urethrally. Anticholinergics were started in the postoperative period. With anticholinergics and clean intermittent catheterization the child has a dry interval of 4 hours. Postoperative urodynamic study was done in the fourth week after surgery and revealed a functional bladder capacity of 100 ml with detrusor pressures in a physiologically safe range [Figure 2].


Robotic augmentation ileocystoplasty with bilateral ureteric reimplantation in a young child with neuropathic bladder.

Chowdhary SK, Kandpal DK, Agarwal D, Sibal A, Srivastava RN - J Indian Assoc Pediatr Surg (2014)

Postoperative cystometry showing functional bladder capacity of 100 ml with detrusor pressure in physiological limits
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4155634&req=5

Figure 2: Postoperative cystometry showing functional bladder capacity of 100 ml with detrusor pressure in physiological limits
Mentions: In the postoperative period morphine infusion was given for pain relief for 48 hours. The abdominal drain was removed on third postoperative day. Oral feedings were started on fifth postoperative day. A check Cystogram was done at 2 weeks which revealed no vesicoureteric reflux and a bladder capacity of 100 ml. The suprapubic drain and DJ stents were removed. The urethral catheter was removed and child was started on intermittent clean catheterization per urethrally. Anticholinergics were started in the postoperative period. With anticholinergics and clean intermittent catheterization the child has a dry interval of 4 hours. Postoperative urodynamic study was done in the fourth week after surgery and revealed a functional bladder capacity of 100 ml with detrusor pressures in a physiologically safe range [Figure 2].

Bottom Line: The management starts early in life.The open surgery has proven safety and success over many decades.The emergence of robotic technology has revived the interest in minimally invasive approach for complex pediatric urological reconstructions.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Urology and Pediatric Surgery, Indraprastha Apollo Hospitals, New Delhi, India.

ABSTRACT
Neuropathic bladder in children is most commonly secondary to spina bifida. The management starts early in life. The modalities of treatment vary depending on the severity of the symptoms. A proportion of children inspite of adequate medical management need augmentation ileocystoplasty later in life. The open surgery has proven safety and success over many decades. Earlier attempts to perform augmentation cystoplasty by the laparoscopic approach were limited by steep learning curve, long operating times, and technical difficulties in intracorporeal anastomosis. The emergence of robotic technology has revived the interest in minimally invasive approach for complex pediatric urological reconstructions. In the recent times, there has been only one reported case report and small series of pediatric robotic augmentation cystoplasty from Chicago. We report the first minimally invasive robotic reconstruction in a child with neuropathic bladder and early renal decompensation despite appropriate medical treatment, from our country.

No MeSH data available.


Related in: MedlinePlus