Children’s Hospital of Pittsburgh of UPMC Study Reveals Success Rate of Minimally Invasive Surgical Approaches in Infants
PITTSBURGH, April 10, 2013
– Blockage between the kidney and the ureter in infants can be successfully repaired with minimally invasive surgical approaches, according to a Children’s Hospital of Pittsburgh
of UPMC study. The findings are published in the April issue of The Journal of Urology.
Ureteropelvic junction (UPJ) obstruction is the most common obstructive urinary system disease in infants, according to senior investigator Michael Ost, M.D
., chief, Division of Pediatric Urology
at Children’s Hospital. The problem typically has been repaired with a procedure called pyeloplasty, in which an incision is made in the infant’s side to reach and remove scar tissue where the kidney meets the ureter, the tube that carries urine to the bladder.
The minimally invasive approach – called transperitoneal laparoscopic pyeloplasty, which can also be done with robot assistance – has emerged as a safe, effective alternative to the standard open pyeloplasty. Both laparoscopic and open pyeloplasty have comparable effectiveness in pediatric patients, but the role of infants is less well defined.
“This population can be challenging to treat laparascopically because of the small size of the abdomen and caliber of the ureter,” Dr. Ost said.
His team reviewed records of 29 children younger than 12 months old treated with transperitoneal laparoscopic pyeloplasty for UPJ obstruction from May 2005 to February 2012. Of the 24 patients for whom follow-up data was available, 22 (92 percent) had successful repairs. Two patients required a second, open procedure to correct the obstruction.
“Our results show the laparoscopic approach is a safe and effective option for the surgical management of UPJ obstruction in the infant population,” said Dr. Ost. “Our early experience reveals a developing success rate comparable to that of other treatment modalities with minimal morbidity.”
Children's is a national leader in minimally invasive procedures, having performed more than 1,000 such surgeries in the last year. So far in fiscal year 2013, Children’s surgeons have performed more than 760 MIS operations.
Children’s is also one of just a handful of pediatric hospitals in the world that features the top-of-the-line surgical robot system, called the daVinci SI Dual Consol Surgical System. The technology allows Children’s surgeons to perform some minimally invasive procedures that in the past couldn’t be performed laproscopically. Increasingly complex, delicate operations can be done through very small surgical openings by specially trained surgeons through the use of the daVinci. Growth in robotic procedures has increased markedly across surgical services.