{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T17:30:12Z","timestamp":1772645412092,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"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>Background\/Objectives: The Mitrofanoff appendicovesicostomy (MAV) is the gold standard for creating a continent catheterizable channel in children unable to perform clean intermittent catheterization (CIC) through the native urethra. Minimally invasive surgery has progressively replaced open techniques in pediatric urology, offering improved recovery and favorable cosmetic outcomes, and robotic-assisted Mitrofanoff has gained popularity in recent years. However, the high costs and limited availability of robotic systems create disparities in access to pediatric urologic reconstruction, particularly in low- and middle-income countries. In this context, the laparoscopic Mitrofanoff (MAV-L) and the laparoscopic-assisted Mitrofanoff (MAV-LA) represent practical, cost-effective alternatives, valuable in institutions without robotic platforms or in resource-limited settings. Recent evidence demonstrates that advanced laparoscopic approaches remain feasible even for complex urological procedures, supporting their continued relevance in the robotic era. Methods: We conducted a retrospective case series including seven male children (aged 9\u201312 years) who underwent MAV between 2018 and 2023. Peri-operative data included demographics, operative time, length of hospitalization, and complications. Functional and aesthetic outcomes were assessed during long-term follow-up. Statistical analysis accounted for the small sample size by using non-parametric tests where appropriate. Results: Three patients (43%) underwent MAV-L and four (57%) MAV-LA. Mean operative time appeared longer in MAV-L (273.3 \u00b1 20.5 min) than in MAV-LA (203.8 \u00b1 24.3 min; exploratory p = 0.019). Hospital stay was 9 \u00b1 0.8 days vs. 7.5 \u00b1 0.5 days (p = 0.026). During follow-up (43.3 \u00b1 10.9 vs. 26.3 \u00b1 5.4 months; p = 0.034), two complications occurred, both in the MAV-L group (stomal stenosis and channel leakage). All patients reported excellent continence, ease of catheterization, and high cosmetic satisfaction. Conclusions: Both laparoscopic and laparoscopic-assisted Mitrofanoff techniques are safe, feasible, and effective in children. Favorable cosmetic satisfaction was reported in the fully laparoscopic subgroup, based on subjective assessment. Importantly, these laparoscopic techniques are sustainable alternatives to robotic surgery, offering accessibility and high-quality reconstructive care even in centers with limited financial and technological resources.<\/jats:p>","DOI":"10.3390\/jcm15051954","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T13:11:36Z","timestamp":1772629896000},"page":"1954","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive Mitrofanoff in Children: Versatile Laparoscopic Strategies\u2014From Low-Resource to Non-Robotic High-Cost Settings in an Exploratory Case Series"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5438-3877","authenticated-orcid":false,"given":"Elisa","family":"Cerchia","sequence":"first","affiliation":[{"name":"Pediatric Urology Unit, Department of Public Health and Paediatric Sciences, Regina Margherita Children\u2019s Hospital, University Hospital of Health and Science, 10122 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Serpentino","sequence":"additional","affiliation":[{"name":"Pediatric Urology Unit, Department of Public Health and Paediatric Sciences, Regina Margherita Children\u2019s Hospital, University Hospital of Health and Science, 10122 Turin, Italy"},{"name":"Pediatric Surgery Unit, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3295-7829","authenticated-orcid":false,"given":"Viet","family":"Nguyen Duy","sequence":"additional","affiliation":[{"name":"Surgical Department, National Hospital of Pediatrics, Dong Da District, Hanoi 100000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Cirigliano","sequence":"additional","affiliation":[{"name":"Pediatric Urology Unit, Department of Public Health and Paediatric Sciences, Regina Margherita Children\u2019s Hospital, University Hospital of Health and Science, 10122 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Catti","sequence":"additional","affiliation":[{"name":"Pediatric Urology Unit, Department of Public Health and Paediatric Sciences, Regina Margherita Children\u2019s Hospital, University Hospital of Health and Science, 10122 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8413-1910","authenticated-orcid":false,"given":"Quang Thanh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Surgical Department, National Hospital of Pediatrics, Dong Da District, Hanoi 100000, Vietnam"},{"name":"College of Health Sciences, VinUniversity, Hanoi 10000, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Caione","sequence":"additional","affiliation":[{"name":"Independent Researcher, 00100 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2279-8661","authenticated-orcid":false,"given":"Simona","family":"Gerocarni Nappo","sequence":"additional","affiliation":[{"name":"Pediatric Urology Unit, Department of Public Health and Paediatric Sciences, Regina Margherita Children\u2019s Hospital, University Hospital of Health and Science, 10122 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"ref_1","first-page":"297","article-title":"Trans-appendicular continent cystostomy in the management of the neurogenic bladder","volume":"21","author":"Mitrofanoff","year":"1980","journal-title":"Chiropr. 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