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Final ID: Poster #: EDU-024

Knowing "Urine" Trouble: Imaging Findings of Robotic-Assisted Laparoscopic Surgery Complications in Pediatric Urology

Purpose or Case Report: Robotic-assisted laparoscopic surgery (RALS) has gained an upsurge in attention within the past two decades and now rivals many of the gold standard, open surgical procedures in pediatric urology. Since the first published cases of pediatric robotic surgery in 2001, case volumes of genitourinary RALS in children have increased exponentially. Given similar complication rates to their open surgical counterparts, and with the benefits of decreased pain medication usage and length of hospitalization, urologic procedures in children such as pyeloplasty, ureteral reimplantation, nephrectomy, and Mitrofanoff appendicovesicostomy will likely continue to see growth in the upcoming years. However, like many innovative technologies, RALS require years of experience to understand the operating control systems, to develop manual dexterity, and to master the technical aspects of specific procedures. As more hospitals and trainees are exposed to systems such as the Da Vinci Surgical System and new upcoming robotic platforms, such as the Senhance Surgical Robotic System, surgeons and radiologists alike will need to recognize common RALS-associated complications on imaging.

This educational exhibit will educate non-surgical physicians on the basic steps of common RALS and provide both pediatric radiologists and pediatric urology surgeons with specific radiographic findings of their complications. Images will include expected post-operative findings, general complications such as hematomas, anastomotic leak, and infection/abscess, as well as more procedure specific complications such as anastomotic stenosis and recurrent ureteropelvic junction obstruction in pyeloplasties. Finally, we will explain and provide images on cases in which interventional radiology can play a pivotal role in the management of pediatric genitourinary RALS complications.

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