{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:11:52Z","timestamp":1788772312103,"version":"build-2803163510"},"reference-count":18,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH-1151502C"],"award-info":[{"award-number":["TCVGH-1151502C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"award":["TCVGH-1151502C"],"award-info":[{"award-number":["TCVGH-1151502C"]}],"id":[{"id":"https:\/\/ror.org\/00e87hq62","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: High-grade vesicoureteral reflux (VUR) may require definitive reconstruction when conservative or endoscopic management fails. Although robot-assisted ureteral reimplantation is increasingly used in children, published experience has predominantly involved an extravesical approach or multiport intravesical surgery. We describe a pure intravesical Cohen reimplantation performed with the da Vinci Single Port (SP) system. Case Presentation: A 7-year-old girl had recurrent febrile urinary tract infections and acute pyelonephritis despite two previous dextranomer\/hyaluronic acid copolymer injections. Voiding cystourethrography demonstrated persistent bilateral VUR (right grade V and left grade IV). Technetium-99m dimercaptosuccinic acid renal scintigraphy showed differential renal function of 38.98% on the right and 61.02% on the left, with cortical defects consistent with renal scarring. She underwent single-port robot-assisted pneumovesicoscopic bilateral Cohen ureteral reimplantation. The previous injectable material was removed, bilateral cross-trigonal submucosal tunnels were created, and both ureters were reimplanted with interrupted 5-0 polyglactin sutures. The total anesthesia duration, operative duration and console duration was 375 min, 310 min and 250 min, respectively. There was minimal blood loss and no drainage tubes or Double J stents were placed. No intraoperative complication occurred. A transient episode of emesis with stool impaction on postoperative day 2 resolved after a glycerin enema and brief bowel rest. She tolerated a regular diet by postoperative day 4 and was discharged on postoperative day 5. At early 6-month follow-up, the patient remained symptom free and ultrasonography showed no obstruction. Conclusions: This case demonstrates the technical feasibility of a pure intravesical da Vinci SP Cohen reimplantation in a child with refractory bilateral high-grade VUR. Comparative effectiveness of different approaches and longer clinical follow-up are required in the future.<\/jats:p>","DOI":"10.3390\/children13091205","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T08:07:06Z","timestamp":1788768426000},"page":"1205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-Port Robotic-Assisted Pneumovesicoscopic Cohen Ureteral Reimplantation for Persistent High-Grade Bilateral Vesicoureteral Reflux in a Child: A Case Report"],"prefix":"10.3390","volume":"13","author":[{"given":"Bo-Yang","family":"Shie","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung City 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Hsiang","family":"Su","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung City 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4616-437X","authenticated-orcid":false,"given":"Chia-Man","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung City 407219, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei City 112304, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City 402202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7344-5217","authenticated-orcid":false,"given":"Sheng-Yang","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung City 407219, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei City 112304, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City 402202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.jpurol.2009.03.012","article-title":"Transvesicoscopic Cohen ureteric reimplantation for vesicoureteral reflux in children: A single-centre 5-year experience","volume":"5","author":"Valla","year":"2009","journal-title":"J. Pediatr. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.1016\/j.jpedsurg.2008.08.057","article-title":"Comparing open and pneumovesical approach for ureteric reimplantation in pediatric patients: A preliminary review","volume":"43","author":"Chung","year":"2008","journal-title":"J. Pediatr. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"513.e1","DOI":"10.1016\/j.jpurol.2019.05.033","article-title":"Comparison of open and pneumovesical approaches for Politano\u2013Leadbetter ureteric reimplantation: A single-center long-term follow-up study","volume":"15","author":"Tae","year":"2019","journal-title":"J. Pediatr. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.urology.2024.02.039","article-title":"Pneumovesicoscopic transvesical ureteric reimplantation for the correction of congenital lower ureteric anomalies in children: A regional Arabian Gulf multicenter retrospective experience","volume":"187","author":"Aljneibi","year":"2024","journal-title":"Urology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"224.e1","DOI":"10.1016\/j.jpurol.2021.12.004","article-title":"Pneumovesicoscopic ureteral reimplantation with intravesical tailoring of obstructive megaureter in pediatric patient","volume":"18","author":"Rudin","year":"2022","journal-title":"J. Pediatr. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/iju.12702","article-title":"Transvesicoscopic ureteral reimplantation: Politano\u2013Leadbetter versus Cohen technique","volume":"22","author":"Soh","year":"2015","journal-title":"Int. J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"413.e1","DOI":"10.1016\/j.jpurol.2021.02.007","article-title":"Ureteral reimplantation aligned laparoscopically: Pneumovesicoscopic Politano\u2013Leadbetter reimplantation in children","volume":"17","author":"Demirel","year":"2021","journal-title":"J. Pediatr. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.urology.2021.06.043","article-title":"Robot-assisted laparoscopic extra-vesical ureteral reimplantation (RALUR\/REVUR) for pediatric vesicoureteral reflux: A systematic review of literature","volume":"156","author":"Esposito","year":"2021","journal-title":"Urology"},{"key":"ref_9","first-page":"23","article-title":"Computer-assisted laparoscopic pneumovesical ureter reimplantation a.m. Cohen: Initial experience in a pig model","volume":"109","author":"Olsen","year":"2003","journal-title":"APMIS Suppl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1089\/end.2005.19.618","article-title":"Intravesical robotically assisted bilateral ureteral reimplantation","volume":"19","author":"Peters","year":"2005","journal-title":"J. Endourol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1016\/j.juro.2010.12.069","article-title":"Robotic-assisted laparoscopic ureteral reimplantation in children: Case-matched comparative study with open surgical approach","volume":"185","author":"Marchini","year":"2011","journal-title":"J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1089\/lap.2020.0401","article-title":"Robotic-assisted vesicoscopic Cohen\u2019s reimplantation in pediatric patient: Nuances of technique, experience, and outcome","volume":"30","author":"Kanojia","year":"2020","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s11934-024-01231-7","article-title":"Implementation and utility of the da Vinci SP (single port) in pediatric urology","volume":"26","author":"Arney","year":"2025","journal-title":"Curr. Urol. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"He, Y., Lin, S., Xu, X., He, S., Xu, H., You, G., Chen, J., and Xu, D. (2023). Single-port-plus-one robot-assisted laparoscopic modified Lich\u2013Gregoir direct nipple ureteral extravesical reimplantation in children with a primary obstructive megaureter. Front. Pediatr., 11.","DOI":"10.3389\/fped.2023.1238918"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Chen, J., Kang, Y., Lin, S., He, S., He, Y., Xu, X., Xu, H., You, G., and Xu, D. (2024). Single-port plus one in pediatric robotic-assisted Lich\u2013Gregoir ureteral reimplantation for vesicoureteral reflux, a comparative analysis with short-term outcomes. BMC Urol., 24.","DOI":"10.1186\/s12894-024-01467-y"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zheng, S., Chen, S., Cui, X., and Zhou, C. (2026). 5G remote-controlled snake-arm single-port robotic pneumovesical Cohen ureteroneocystostomy: First animal study. Front. Pediatr., 14.","DOI":"10.3389\/fped.2026.1760104"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/nau.22751","article-title":"The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the Standardization Committee of the International Children\u2019s Continence Society","volume":"35","author":"Austin","year":"2016","journal-title":"Neurourol. Urodyn."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/0090-4295(83)90079-1","article-title":"Estimating bladder capacity in children","volume":"21","author":"Koff","year":"1983","journal-title":"Urology"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1205\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T08:50:54Z","timestamp":1788771054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":18,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["children13091205"],"URL":"https:\/\/doi.org\/10.3390\/children13091205","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}