Robotic Laparoscopic Surgery
in Pediatric Urology

Advancing minimally invasive techniques to improve outcomes for children with complex urologic conditions

Minimally invasive surgery (MIS) has transformed pediatric surgical care over the past several decades. Laparoscopy was first introduced in pediatric surgery in the 1970s for diagnostic purposes.¹ Therapeutic applications soon followed, including laparoscopic cholecystectomy in 1985 and nephrectomy in 1990.²^,³ Since that time, MIS has become standard of care for many pediatric and adult surgical conditions.

MIS techniques rely on one or several small incisions, typically less than one centimeter, to introduce a camera and instruments into the body. Compared to open surgery, MIS offers several advantages for both pediatric and adult patients. These include reduced postoperative pain, decreased narcotic use, less scarring, shorter hospital stays and faster return to activity. Multiple studies have demonstrated that MIS
is both safe and effective in children.

Evolution of Robotic-Assisted Surgery

Although commonly described as “robotic surgery,” the system is more accurately characterized as robotic-assisted laparoscopic surgery, as it is entirely surgeon-controlled. 

The technology was developed to address limitations of conventional laparoscopy, including two-dimensional visualization and restricted instrument articulation. Robotic-assisted systems overcome these challenges by offering three-dimensional visualization, magnification, tremor elimination and wrist-like instrument articulation. 

These capabilities have made robotic-assisted surgery particularly well suited for pediatric urologic reconstructive procedures, where precision is critical.

Clinical Impact in Pediatric Urology

In pediatric urology, procedures that once required open surgery can now be performed safely with robotic assistance, often with equal or improved surgical outcomes.

Children undergoing robotic-assisted procedures frequently return home the day after surgery with less discomfort than those undergoing open surgery. At Children’s Wisconsin, robotic-assisted laparoscopic surgery is offered for the following conditions:

• Bladder surgery

• Genitourinary reconstructive procedures

• Nephrectomy and nephroureterectomy

• Pyeloplasty for ureteropelvic junction obstruction

• Ureteral reimplantation for vesicoureteral reflux

Robotic Surgical Expertise
at Children’s Wisconsin

Robotic-assisted laparoscopic surgery highlights how technology continues to advance pediatric surgical care. Successful outcomes depend on
a team experienced in both pediatric disease and robotic techniques.

At Children’s Wisconsin, a dedicated robotic surgery program supports this work, including an in-house da Vinci Surgical System and five fellowship-trained pediatric urologists who are trained in robotic-assisted laparoscopic surgery: Elizabeth Roth, MD; Jonathan Ellison, MD; Susan Jarosz, DO; Doug Storm, MD; and Travis W. Groth, MD.

Children’s Wisconsin continues to invest in minimally invasive and robotic-assisted technologies to expand access to advanced surgical care tailored to pediatric patients.

References:

1.  Gans SL, Berci G. Advances in endoscopy of infants and children.
J Pediatr Surg, 1971. 6(2):199–233.

2. Reynolds Jr W. The first laparoscopic cholecystectomy. JSLS, 2001. 5(1):89–94.

3. Clayman RV, et al. Laparoscopic nephrectomy: initial case report. J Urol, 1991. 146(2):278–82.