Current trends in application of laparoscopic and robotic technologies in pediatric urology
Purpose In this study we sought to capture current trends of laparoscopic and robotic technologies and its predicted future application in pediatric urology. Material and Methods An electronic survey was distributed among pediatric urologists through Society of Endourology, Section of Urology of American Academy of Pediatricians, and European Society of Pediatric Urologists. The survey addressed details of training, type of practice, number and type of procedures performed, and use of laparoscopy or robotics technology. Results A total of 91 pediatric urologists replied to the survey. Most of the participants were fellowship trained. 52.1% were practicing for more than 10 years. The academic set up was 62.8%. 60% use robot-assisted laparoscopy, while 99% use laparoscopy. Thirty two percent perform 50-100 laparoscopic procedures annually, 23% of cases are performed with robot-assisted laparoscopy. Half of respondents have experience with robotics and 24% have been using it for 2-5 years. Pyeloplasty is the preferred procedure for robotic approach in 41%, followed by reimplantation. The reported advantages of robotic technology are improved dexterity (47%), being less physically demanding (40%) and more accurate (40%). The DaVinci system is shared with adult urologist in 86%, 25% have S system with HD and 81% use 8 mm ports. Finally, almost half of respondents who do not use the robot, anticipate using it in the future. Conclusions Laparoscopy became a standard tool in Pediatric Urology armamentarium. There is current and anticipated increase in the use of Robotic technology. The advantages reported are the dexterity and precision in reconstructive surgery.