Pediatric urologists at Cincinnati Children’s are expanding their use of robot-assisted surgery, particularly in cases involving the upper urinary tract. They employ the technology most frequently for pyeloplasty, often using a stentless technique. Other urologic surgeries that lend themselves to the robotic approach include ureteroureterostomy, ileal conduit and urinary tract reconstructions, including the Mitrofanoff procedure. The robot’s laparoscopic ports and visualization capabilities mean smaller, less painful incisions, less blood loss and a shorter recovery. Michael Daugherty, MD, prefers to do pyeloplasties robotically, regardless of the patient’s size or age, partly because it provides better access to the kidney. Daugherty uses the stentless technique about 70% of the time. This eliminates the need for a second surgery to remove the stent.  

“Our team has done about 150 stentless pyeloplasties here in the last seven years, some on patients who weigh less than 5 kilograms,” Daugherty says. “We’re working on a publication comparing stentless to stented pyeloplasties, and our preliminary data show no difference in complications or outcomes.” 

Daugherty is one of four pediatric urologists at Cincinnati Children’s who performs robotic surgeries. In the last year, he and his colleagues have expanded their “robotic repertoire” to oncology cases, such as renal tumor resections and retroperitoneal lymph node dissections for paratesticular cancer.  

“Our robotic surgery program is fairly high volume and growing, but robotic surgery isn’t the automatic choice for every case,” Daugherty says. “Open procedures are still preferred for many procedures, such as Wilms’ tumor resection and ureteral reimplantation. We’re glad to have many tools and techniques at our disposal to achieve the best outcomes possible for children with urologic issues.”  

To learn more, contact Michael.Daugherty@cchmc.org.