WOFAPS 2025 8th World Congress of Pediatric Surgery

Giancarlo Sanchez-Salazar ¹, Pablo Guaman-Ludeña ¹, Paul Astudillo-Neira ²

¹ San Francisco de Quito, University
² Carlos Andrade Marin Hospital, Department of Pediatric Surgery

Purpose

Vesicoureteral reflux (VUR) is a prevalent pediatric condition associated with recurrent urinary tract infections and potential renal damage. While open ureteral reimplantation remains the gold standard, robotic-assisted extravesical ureteral reimplantation (RAEVUR) has emerged as a minimally invasive alternative with promising outcomes. This study aimed to describe the surgical outcomes, complications, and efficacy of RAEVUR in pediatric patients at a public tertiary hospital in Latin America.

Methods

A retrospective descriptive study was conducted including pediatric patients (0–17 years) who underwent robot-assisted extravesical Lich-Gregoir ureteral reimplantation between January 2021 and May 2025 at the Hospital de Especialidades Carlos Andrade Marín. Variables analyzed included demographics, diagnosis and VUR grade, operative and console times, hospital stay, surgical success (defined as radiological resolution of reflux), postoperative urinary tract infections (UTIs), and perioperative complications.

Results

Nine patients were included (mean age 6.8 years; 55% female). Unilateral VUR was present in 77%, bilateral in 33%, and ureterovesical junction obstruction in 11%. The average operative time was 144.6 minutes, console time 122.8 minutes, and hospital stay 4.3 days. The surgical success rate was 93.3%, with only two postoperative UTIs and no significant intra- or postoperative complications. No conversions to open surgery, ureteral obstruction, or urinary leaks were reported. Among bilateral VUR cases, unilateral reimplantation was performed when contralateral reflux was low-grade and non-surgical.

Conclusion

Robotic-assisted extravesical ureteral reimplantation is a safe and effective technique in the pediatric population, with low complication rates and high success in reflux resolution. Its implementation in Latin American public hospitals demonstrates promising outcomes and supports its broader adoption in similar settings.