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Correspondence to Author: M. Ruiz, L Zelaya, V Vargas, JI Garrido, RM Paredes, A Parente.. 

Pediatric Surgery Department, Reina Sofia University Hospital. Cordoba, Spain

DOI: 10.52338/airs.2025.5237

Abstract:

Objective: To assess the learning curve and the influence of patient age on operative times in pediatric robotic pyeloplasty, and to determine the safety and effectiveness of the procedure based on our institutional experience.
Methods: A retrospective observational study was conducted including 16 pediatric patients diagnosed with ureteropelvic junction obstruction (PUJO) who underwent robotic-assisted pyeloplasty using the Da Vinci Xi system between 2022 and 2025. Clinical and surgical variables were analyzed, including age, laterality, etiology, docking and closure time (DCT), console time (CT), total operative time (TOT), and complications. To evaluate the learning curve, cases were divided chronologically into three groups of five patients each. Linear regression analysis and ANOVA tests were used to assess correlations between case number, patient age, and operative times.
Results:Eighty percent of the obstructions were left-sided, and 53% were intrinsic. The mean patient age at surgery was 65 months. No conversion to open surgery was required. The mean DCT was 47 minutes, CT was 102 minutes, and TOT was 149 minutes. A significant correlation was found between the number of cases and the reduction in DCT (R=0.678, p<0.05), indicating progressive improvement with surgical experience. No correlation was observed between patient age and operative times. No major intraoperative or postoperative complications were reported.
Conclusion: Robotic-assisted pyeloplasty is a safe and effective approach for pediatric PUJO. Operative times decrease with increasing surgical experience, reflecting a relatively short learning curve, while patient age does not significantly impact technical complexity or operative duration.

Keywords: Pediatric surgery, Robotic surgery, pyeloplasty, children

Citation:

A Parente, Learning Curve and the Influence of Patient Age on Operative Times in Pediatric Robotic Pyeloplasty: A Single-Center Experience. Advances in Robotic Surgery 2025.