Long-term surgical outcomes of robotic versus open bladder neck reconstruction in a pediatric population.

INTRODUCTION

Robotic bladder neck procedures may offer unique benefits including improved visualization and suturing dexterity compared to an open approach. Our aim was to compare the short and long-term clinical outcomes of pediatric patients undergoing robotic versus open bladder neck reconstruction with slings at a single institution.

MATERIALS AND

METHODS

A retrospective review was performed of pediatric patients with neurogenic bladders undergoing robotic or open bladder neck reconstruction with slings between January 2015-July 2024. All open procedures were performed by one of three surgeons, and all robotic procedures were performed by one of two surgeons at a single institution. Patient demographics, intra-operative, and post-operative outcomes were collected and compared using Fischer's exact and Wilcoxon rank-sum tests, as appropriate. A p-value of ≤0.05 was considered statistically significant.

RESULTS

A total of 59 patients were identified (22 robotic and 37 open), with a median follow-up length of 5.5 years (interquartile range: 2.7-7.5 years). The robotic group had a significantly longer operative time (457.5 vs 275.0 min, p = 0.01). There was no significant difference in continence rates (86% vs 89% p = 1.00), 30-day complication rates (41% vs 38%, p = 1.00) or surgical revision rates (36% vs 46%, p = 0.80) between the robotic and open groups. The robotic group had a significantly shorter hospital stay even when excluding patients who underwent a concomitant augment or Monti creation (5.0 vs 8.0 days, p = 0.01).

CONCLUSION

Robotic bladder neck reconstruction in a pediatric population is feasible with similar post-operative outcomes compared to an open approach with the benefit of significantly shorter hospital stays.