Robot-assisted laparoscopic pyeloplasty in infants using 5-mm instruments

Background: Utilization of the robotic approach to pyeloplasty continues to grow in the field of pediatric urology. Adoption in the infant population has perhaps been the slowest because of the limited operative domain and relatively large instruments. Method: In this video, we demonstrate key steps in performing an infant robotic pyeloplasty using the smallest instruments currently available for the da Vinci S and Si systems (Intuitive Surgical, Sunnyvale, California). Results: At our institution, 20 robot-assisted laparoscopic infant pyeloplasties have been performed using 5-mm instruments. There have been no conversions to an open approach. The patient age ranged from 2 to 9 months old. The average operative time was 2 h and 28 min. Conclusion: The treatment success rate was 95% at an average of 8.3 months of follow-up.