Robot assisted laparoscopic pyeloplasty in obese and non-obese patients

ObjectiveWe assessed whether increased BMI has a negative impact in children undergoing robot assisted laparoscopic pyeloplasty (RALP).Patients and methodsRecords of patients who underwent RALP were retrospectively reviewed and separated into healthy weight, overweight, and obese cohorts based on age-adjusted BMI percentile, and surgical and postsurgical outcomes were evaluated.ResultsOf the 103 patients, there were 79 healthy weight and 24 overweight, with 10 of the 24 considered obese (BMI <85th, ≥85th, and ≥95th percentile for age, respectively). Cohorts were similar in respect to age, sex, laterality and symptoms. Operative time (234 min, 241 min, p = 0.642; 254 min, p = 0.324), EBL (7.1 ml, 10.5 ml, p = 0.293; 6.8 ml, p = 0.906), length of stay (1.2d, 1.2d p = 0.545; 1.1d p = 0.550), and narcotic administration (0.25 mg/kg, 0.25 mg/kg, p = 0.545; 0.13 mg/kg, p = 0.430) were similar between healthy weight, overweight, and obese cohorts, respectively. Complication rates were similar in regard to minor and major complications. There was no difference in decreased hydronephrosis (92.2%, 89.6%, p = 0.440; 88.9%, p = 0.730). Four patients (3.4%) required a reoperative procedure (three healthy weight, one overweight; p = NS).ConclusionsDespite the potential difficulties with surgery in overweight patients, our data indicate that robot-assisted laparoscopic pyeloplasty can be performed as safely and effectively in overweight or obese children as in healthy weight children.