One Anaesthesia, One Surgery: Synchronous Bilateral Robot-Assisted Laparoscopic Pyeloplasty in a 1.5-Month-Old Infant

Abstract

Background:
Robot-assisted laparoscopic pyeloplasty (RALP) is increasingly being utilized for pediatric ureteropelvic junction obstruction (UPJO). It is reported to offer outcomes comparable to open surgery. However, its application in infants is technically challenging due to limited
intraperitoneal space and potential instrument collision. In cases of bilateral UPJO, synchronous bilateral repair provides advantages of reduced anesthesia exposure and shorter hospital stay, but its use in very young infants remains scarcely reported.
Case Report:
We report the case of a 1.5-month-old male with antenatally detected bilateral hydronephrosis. Postnatal imaging and renography confirmed obstructed bilateral UPJO with suboptimal renal function. Following recurrent episodes of urinary tract infection he underwent synchronous bilateral RALP using the da Vinci Si system.
Conclusion:
This case demonstrates the technical feasibility and safety of synchronous bilateral RALP in very young infants. Benefits of single-stage robotic approach reduces