{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:09:05Z","timestamp":1783523345206,"version":"3.55.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aims to analyze the outcomes of robot-assisted laparoscopic pyeloplasty (RALP) in children with pelvi-ureteric junction obstruction (PUJO) over a 10-year period at a tertiary care center in South India.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study provides a detailed analysis of prospectively acquired data from 2013 to 2023 of all children who underwent RALP at our institution. Pre- and post-operative renal ultrasound and isotope renography were used to assess outcomes. Detailed information on patient demographics, procedural duration, post-operative pain relief, operation steps, and post-surgical follow-up protocols has been provided. The analysis included all patients who completed a 1-year follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Between 2013 and 2023, 201 children underwent RALP. Of these, 185 children completed at least 1\u2005year of follow-up and were included in the analysis. The mean age of the cohort was 4.9\u2005years (1\u2005month to 17\u2005years), with males comprising the majority (77.3%). Twenty-five children (13.5%) were younger than 1\u2005year of age. Left-sided PUJO was found to be more common. The mean console time was 76.5\u2005min (40\u2013180\u2005min), and the average hospital stay was 2.8\u2005days (2\u20135). After surgery, the mean reduction in antero-posterior diameter of the renal pelvis was more than 50% of its pre-operative value and statistically significant (3.3\u2009\u00b1\u20090.3 to 1.9\u2009\u00b1\u20090.9\u2005cm). At the end of 1 year, the overall reduction in renal size was also significant (9.7\u2009\u00b1\u20092.3\u2005cm pre-operative to 8.9\u2009\u00b1\u20091.8\u2005cm post-operative). The pre-operative Society of Fetal Urology (SFU) grade of hydronephrosis was compared to the post-operative SFU grade, and the improvement (resolution\/downgrading) was found to be statistically significant. The median split renal function in this series was 39% pre-operative and 43% post-operative, and the overall functional improvement after RALP was significant. A successful outcome was observed in 181 children (97.8%). Four children experienced persistent severe hydronephrosis and underwent redo stenting and\/or redo pyeloplasty (2.1% failure rate). Post-operative complications, according to the Clavien\u2013Dindo classification, were classified as type 1 in three children and type 3b in two children. There were no conversions to open surgery in the series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>RALP emerges as the minimally invasive procedure of choice for children with PUJO at our institution. It is safe, delivering consistently excellent results and minimal complications. Our outcomes are comparable to those of previously published series. We trust that our experience will serve as a roadmap for those centers (especially in South Asia) embarking on a pediatric robotic program.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1376644","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T04:58:16Z","timestamp":1719377896000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Analysis of outcomes of robot-assisted laparoscopic pyeloplasty in children from a tertiary pediatric center in South India"],"prefix":"10.3389","volume":"12","author":[{"given":"Tamizhvanan","family":"Vidhya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padankatti","family":"Rajiv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkat","family":"Sripathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1111\/j.1464-410X.1973.tb06804.x","article-title":"The long-term follow-up of Anderson-Hynes pyeloplasty for hydronephrosis","volume":"45","author":"Notley","year":"1973","journal-title":"Br J Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1007\/s00383-017-4082-7","article-title":"Robot-assisted laparoscopic pyeloplasty in the pediatric population: a review of technique, outcomes, complications, and special considerations in infants","volume":"33","author":"Boysen","year":"2017","journal-title":"Pediatr Surg Int"},{"key":"B3","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1308\/003588414X14055925058797","article-title":"Evaluation of robotic-assisted laparoscopic and open pyeloplasty in children: single-surgeon experience","volume":"97","author":"Murthy","year":"2015","journal-title":"Ann R Coll Surg Engl"},{"key":"B4","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1007\/s00383-016-3869-2","article-title":"Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery","volume":"32","author":"Sal\u00f6","year":"2016","journal-title":"Pediatr Surg Int"},{"key":"B5","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.euros.2022.05.009","article-title":"Transperitoneal versus retroperitoneal robotic-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction in children. A multicentre, prospective study","volume":"41","author":"Blanc","year":"2022","journal-title":"Eur Urol Open Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s11701-009-0164-4","article-title":"Prospective analysis of completely stentless robot-assisted pyeloplasty in children","volume":"3","author":"Casale","year":"2010","journal-title":"J Robot Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"229.e1","DOI":"10.1016\/j.jpurol.2016.04.007","article-title":"Global minimally invasive pyeloplasty study in children: results from the pediatric urology expert group of the European Association of Urology Young Academic Urologists working party","volume":"12","author":"Silay","year":"2016","journal-title":"J Pediatr Urol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1016\/S0022-5347(05)00183-7","article-title":"Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery","volume":"175","author":"Lee","year":"2006","journal-title":"J Urol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1007\/s00383-015-3748-2","article-title":"Factors associated with age at pyeloplasty in children with ureteropelvic junction obstruction","volume":"31","author":"Vemulakonda","year":"2015","journal-title":"Pediatr Surg Int"},{"key":"B10","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s11934-009-0010-2","article-title":"Robotic pyeloplasty in the pediatric population","volume":"10","author":"Casale","year":"2009","journal-title":"Curr Urol Rep"},{"key":"B11","doi-asserted-by":"publisher","first-page":"102.e1","DOI":"10.1016\/j.jpurol.2020.10.031","article-title":"Resolution of hydronephrosis after pyeloplasty in children","volume":"17","author":"V\u00e4rel\u00e4","year":"2021","journal-title":"J Pediatr Urol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.urology.2018.08.010","article-title":"Hydronephrosis after pyeloplasty: \u201cwill it go away?\u201d","volume":"121","author":"Carpenter","year":"2018","journal-title":"Urology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"228.e1","DOI":"10.1016\/j.jpurol.2016.04.003","article-title":"Percent improvement in renal pelvis antero-posterior diameter (PI-APD): prospective validation and further exploration of cut-off values that predict success after pediatric pyeloplasty supporting safe monitoring with ultrasound alone","volume":"12","author":"Rickard","year":"2016","journal-title":"J Pediatr Urol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1016\/j.juro.2010.11.056","article-title":"Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults","volume":"185","author":"Minnillo","year":"2011","journal-title":"J Urol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"102.e1","DOI":"10.1016\/j.jpurol.2015.08.015","article-title":"Ninety-day perioperative complications of pediatric robotic urological surgery: a multi-institutional study","volume":"12","author":"Dangle","year":"2016","journal-title":"J Pediatr Urol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1007\/s11701-023-01559-1","article-title":"Robotic-assisted pyeloplasty in children: a systematic review of the literature","volume":"17","author":"Esposito","year":"2023","journal-title":"J Robot Surg"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1376644\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T04:58:18Z","timestamp":1719377898000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1376644\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,26]]},"references-count":16,"alternative-id":["10.3389\/fped.2024.1376644"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1376644","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,26]]},"article-number":"1376644"}}