Implementation of robot-assisted laparoendoscopic single-port surgery in infant urology.

OBJECTIVE

To evaluate the feasibility and effectiveness of robot-assisted laparoendoscopic single-port surgery (R-LESS) in infant urology and to report our early single-center experience.

METHODS

Clinical data were retrospectively collected from 20 infants (≤ 12 months) who underwent R-LESS using the Da Vinci Xi system between February 2024 and April 2025. Information included demographic characteristics, perioperative parameters, and postoperative outcomes. The median age at surgery was 2.5 (IQR: 2, 4) months. Sixteen patients underwent pyeloplasty, two underwent ureteral reimplantation, and two underwent nephrectomy.

RESULTS

All procedures were completed successfully without conversion to open surgery or intraoperative complications. The median docking time, console time, and total operative time were 7 (IQR: 6, 8) min, 181 (IQR: 156, 207) min, and 212 (IQR: 189, 238) min, respectively. Median estimated blood loss was 5 (IQR: 5, 9) mL. Median total hospital stay was 6 (IQR: 6, 10) days, with a median postoperative stay of 2 (IQR: 1, 4) days. The median follow-up duration was 9.1 (IQR: 5.4, 11.2) months. Postoperative complications were observed in three cases (15%): two patients (10%) developed febrile urinary tract infections (Clavien-Dindo Grade II), which resolved with antibiotic treatment; one patient (5%) required hospital readmission for wound debridement due to poor healing (Clavien-Dindo Grade III), with favorable postoperative recovery.

CONCLUSION

R-LESS is a safe and effective minimally invasive surgical approach in infant urology.