Complications in pediatric robotic urologic surgery

Robotic-assisted laparoscopic surgery, like other minimally invasive surgical modalities, in children with urologic conditions has proven to be a safe and effective alternative to open surgery and especially for reconstructive pediatric urologic procedures. However, potential complications can occur, especially with the learning curve that exists with all new procedures and techniques. The prevention of complications requires an integrated team approach that includes the surgeon, anesthesiologist, and operating room team members. Avoidance of preoperative complications usually involves adequate patient positioning and padding before surgery that prevents peripheral nerve injury. Intraoperative complications can occur during intra-abdominal access and port placement steps of the procedures with the potential for vessel injury or bowel injury. Postoperative complications have a wide variety of presentations that are dependent on the procedure, such as ureteral reimplantation, pyeloplasty, or complex reconstructive procedures. In general, surgeons early in their robotic surgery learning curve should gradually advance to complex reconstructive cases to help prevent both intra- and postoperative complications.