Frequently Asked Questions About Pediatric Robotic Urological Surgery

Robotic-assisted surgery is the newest and most exciting technique in minimally invasive surgery. Offering the precision of traditional open surgery and the shorter recovery time of minimally invasive surgery, robotic-assisted surgery is now available for intricate urological procedures for children.

• How does robotic surgery work?
• Which pediatric urological procedures are being done robotically?
• What are the advantages of robotic surgery?
• Will the robotic surgery be quick?
• How long will it take for my child to recover from surgery?
• Is robotic surgery still in the experimental stage?
• What if the equipment fails during the operation?
• Is robotic surgery covered by insurance?

Q. How does robotic surgery work?

In a robotic procedure, the surgeon controls the robot's movements from a console just a few steps from the patient.

A. Comer Children's Hospital at the University of Chicago uses the da Vinci Surgical System for all robotic surgeries. During a robotic surgery, the patient is in a standard operating room fully staffed by surgeons, anesthesiologists and nurses. After making two to three tiny incisions, the surgeon positions a camera and miniature robotic surgical tools inside the patient's body. While sitting at a console just a few feet away from the patient, the surgeon uses computer controls to manipulate the instruments in the patient's body. The robotic arms function as an extension of the surgeon's hands. A video screen at the operative console gives the surgeon a clear, three-dimensional view of the surgical field.

Q. Which urological procedures are being done robotically?
A. The most common urologic applications for robotic surgery are for ureteropelvic junction obstruction (UPJ), bladder augmentation, appendicovesicostomy and ureteral procedures. Robotic surgery for these and other procedures have proven to give similar results as in open surgery, but with the advantage of smaller incisions and significantly shorter recovery time. As instrumentation continues to improve, more pediatric procedures will likely be performed with robotic assistance.

While robotic surgery can be used for nephrectomy, heminephrectomy and orchidopexy, simple laparoscopy is usually sufficient for these procedures.

The surgeon controls all movements of the system's agile instruments.

Q. What are the advantages of robotic surgery?
A. Patients experience less pain, shorter hospital stays and faster recovery times than they do in traditional surgery. Because the surgeon operates through three to four small incisions (1/3- to 1/2-inch in size) the patient is spared the scarring and pain that is characteristic of large incisions.

Traditional minimally invasive surgeries present some technical limitations for the surgeon. Working with the robotic surgery system gives the surgeon better dexterity, precision and visibility in performing complex surgeries.

Q. Will the robotic surgery be quick?
A. Robotic surgeries may take longer than other types of minimally invasive surgeries due to time needed for positioning the instruments and other equipment. Expert teams can often complete the surgery in the same amount of time as an open surgery.

Q. How long will it take for my child to recover from surgery?
A. Recovery times vary from patient to patient. In general, hospitalization and recovery times for patients who have robotic surgery are much shorter than those who have an open surgery. Children often return to normal activity within a few days, compared to the several weeks necessary after an open surgery.

Q. Is robotic surgery still in the experimental stage?
A. No. Robotic surgery for pediatric urology is new, but not experimental. The safety and feasibility of this procedure have been demonstrated already. Dr. Mohan S. Gundeti, chief of the pediatric urology service at the University of Chicago, is one of the national leaders of robotic surgery in children. Dr. Gundeti is also an expert in all types of laparoscopic and open urologic surgery. » Read a story in the Chicago Tribune about our physicians' expertise in robotic surgery

Q. What if the equipment fails during the operation?
A. This is rare. Should something go wrong with the equipment, the surgeon can do the procedure laparoscopically or is trained to convert to open surgery.

Q. Is robotic surgery covered by insurance?
A. Yes, robotic surgery is covered by insurance. Please be sure to check with your insurance provider regarding your coverage.