WOFAPS 2025 8th World Congress of Pediatric Surgery

Domenica Villacis-Vasquez ¹, Pablo Guaman-Ludeña ², Paul Astudillo-Neira ², Giancarlo Sanchez-Salazar ¹, Yolanda Galvez ¹

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

Purpose: Complete ureteral duplication is a rare urological anomaly, and ectopic ureters occur in approximately 1 in 19,000 live births. In children, these abnormalities are often associated with recurrent urinary tract infections or voiding dysfunctions. When patients are symptomatic, robotic heminephroureterectomy (RHNU) is a minimally invasive surgical procedure to resect the superior renal pole and its respective ureter. We present the results of a series of 7 cases treated with this procedure.

Method: Between January 2022 and June 2025, 7 patients diagnosed with a complete duplex system with ureterocele underwent RHNU. The variables presented are: age, weight, sex, indication for the procedure, operative time, operative bleeding, intraoperative complications, conversion rate, and perioperative complications.

Results: The smallest patient in the series weighed 9 kilograms. The diagnosis for all cases was a complete pyeloureteral duplex system with an associated ureterocele. Operative bleeding was minimal, measuring less than 5 ml. There were no intraoperative complications, and the conversion rate to open surgery was zero.

Conclusion: Robotic heminephroureterectomy offers all the advantages of laparoscopic surgery, with superior hemostasis control due to the versatility of the instrument movements and the availability of hemostatic energy. This could establish it as the gold standard for the treatment of this pathology.