{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:08:03Z","timestamp":1783523283965,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Vesicoureteral reflux (VUR) is a frequent pediatric urological anomaly associated with recurrent urinary tract infections and renal scarring. Evidence on robot-assisted extravesical ureteral reimplantation (RALUR-EV) continues to grow; however, reports from Latin America remain limited. Objectives: We report an initial single-center experience with transperitoneal RALUR-EV (Lich\u2013Gregoir) in a public pediatric hospital in Ecuador, detailing operative metrics, perioperative outcomes, and short-term radiographic efficacy using standardized definitions. Methods: A retrospective, observational study was conducted at a public tertiary referral center in Quito (January 2021\u2013May 2025). Consecutive children (0\u201317 years) with VUR or ureterovesical junction (UVJ) obstruction who underwent RALUR-EV with the Lich Gregoir technique were included. The primary outcome was radiographic resolution of VUR at 3\u20136 months on voiding cystourethrogram. Secondary outcomes were operative times (total, console, docking), length of stay, postoperative UTI (culture-confirmed), and complications (Clavien\u2013Dindo). Analyses were descriptive; success was reported as both evaluable-only and intention-to-treat (ITT). The study received institutional ethics approval. Results: Nine children were included (median age 4.4 years; 5 girls). Eight had VUR (5 unilateral, 3 bilateral); one had isolated UVJ obstruction. Procedures were left-sided in 7 cases and right-sided in 2. Median total operative time was 135 min (IQR 129\u2013153); median console and docking times were 120 and 15 min, respectively. No intraoperative complications or conversions occurred. Median length of stay was 4 days (IQR 3\u20134). Two culture-confirmed postoperative UTIs occurred (2\/9; Clavien II); no complications \u2265 III were observed. Postoperative imaging was available in 6\/9 cases (66.7%): radiographic resolution was 6\/6 (100%) overall and 5\/5 (100%) among VUR-only. ITT success was 6\/9 (66.7%) overall and 5\/8 (62.5%) for VUR-only. Conclusions: Transperitoneal RALUR-EV is feasible and safe in a public tertiary setting, with early effectiveness comparable to international series. Standardized pathways, structured follow-up, and multicenter collaboration are warranted to confirm durability and support broader regional adoption.<\/jats:p>","DOI":"10.3390\/jcm14228120","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T12:55:31Z","timestamp":1763556931000},"page":"8120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robot-Assisted Extravesical Ureteral Reimplantation (RALUR-EV) in Children: Initial Single-Center Experience at a Public Tertiary-Care Hospital in Ecuador"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1308-1156","authenticated-orcid":false,"given":"Giancarlo","family":"S\u00e1nchez-Salazar","sequence":"first","affiliation":[{"name":"Departamento de Cirug\u00eda Pedi\u00e1trica, Hospital Carlos Andrade Mar\u00edn, Quito 170103, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1809-5135","authenticated-orcid":false,"given":"Juan","family":"Cruz-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Departamento de Cirug\u00eda Pedi\u00e1trica, Hospital Carlos Andrade Mar\u00edn, Quito 170103, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4998-0523","authenticated-orcid":false,"given":"Pablo","family":"Guam\u00e1n-Lude\u00f1a","sequence":"additional","affiliation":[{"name":"Departamento de Cirug\u00eda Pedi\u00e1trica, Hospital Carlos Andrade Mar\u00edn, Quito 170103, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Gaibor-Pazmi\u00f1o","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-7498","authenticated-orcid":false,"given":"Esteban","family":"Ortiz-Prado","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-0546","authenticated-orcid":false,"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"L\u00e4ckgren, G., Cooper, C.S., Neveus, T., and Kirsch, A.J. 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