Robot-assisted bladder diverticulum removal in a 10-year-old child

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Abstract

BACKGROUND: Bladder diverticulum are hernias of the bladder mucosa that prolapse through a detrusor defect. Diverticulectomy is the treatment of choice for this disease. Surgical methods to implement this principle include open, laparoscopic and robotic approaches. In the present study, we outline our own technique for performing robotic diverticulectomy and report its short-term results.

CLINICAL CASE DESCRIPTION: The study reports one case of bladder diverticulectomy performed with a robot-assisted technique in a 10-year-old boy. The diagnosis of the disease was established using voiding cystourethrography, cystoscopy and X-ray computed urography. The patient had robot-assisted bladder diverticulectomy using transperitoneal extravesical access. At the final stage of the study, short-term outcomes of the robot-assisted procedure were evaluated. The duration of the operation was 100 minutes. No intraoperative and postoperative complications were observed. The urinary catheter was removed the day after the operation. The duration of the patient's stay in the hospital was 7 days. Histological examination showed signs corresponding to a false diverticulum of the bladder with the presence of single muscle fibers in its structure. The ureteral stent was removed one month after the operation. After removal of the stent, control voiding cystography was performed, which demonstrated the absence of bladder contour deformation at the site of surgical procedure.

CONCLUSION: Robot-assisted bladder diverticulectomy is a technically feasible approach to the treatment of congenital bladder diverticulum.

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About the authors

Yuri A. Kozlov

Irkutsk State Regional Children’s Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education; Irkutsk State Medical University

Author for correspondence.
Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X
SPIN-code: 3682-0832

MD, Dr. Sci. (Medicine), Corresponding Member of the Russian Academy of Sciences

Россия, Irkutsk; Irkutsk; Irkutsk

Simon S. Poloyan

Irkutsk State Regional Children’s Clinical Hospital; Irkutsk State Medical University

Email: simonpoloyan@ya.ru
ORCID iD: 0000-0001-7042-6646

Assistant Lecturer

Россия, Irkutsk; Irkutsk

Eduard V. Sapukhin

Irkutsk State Regional Children’s Clinical Hospital

Email: sapukhin@yandex.ru
ORCID iD: 0000-0001-5470-7384

MD, Cand. Sci. (Medicine)

Россия, Irkutsk

Alexey S. Strashinsky

Irkutsk State Regional Children’s Clinical Hospital

Email: strashinskias@gmail.com
ORCID iD: 0000-0002-1911-4468
Россия, Irkutsk

Marina V. Makarochkina

Irkutsk State Regional Children’s Clinical Hospital

Email: m.makarochkina@gmail.com
ORCID iD: 0000-0001-8295-6687
SPIN-code: 4600-4071
Россия, Irkutsk

Andrey A. Marchuk

Irkutsk State Regional Children’s Clinical Hospital

Email: maa-ped20@yandex.ru
ORCID iD: 0000-0001-9767-0454
Россия, Irkutsk

Alexander P. Rozhansky

Irkutsk State Medical University

Email: alexanderozhanski@mail.ru
ORCID iD: 0000-0001-7922-7600
SPIN-code: 4012-7120
Россия, Irkutsk

Anton A. Byrgazov

Irkutsk State Regional Children’s Clinical Hospital

Email: byrgazov.ant-doc38@yandex.ru
ORCID iD: 0000-0002-9195-5480
Россия, Irkutsk

Sergey A. Muravyov

Irkutsk State Medical University

Email: muravev1999sergey@mail.ru
ORCID iD: 0000-0003-4731-7526

student

Россия, Irkutsk

Artem N. Narkevich

South Ural State Medical University; Voino-Yasenetsky Krasnoyarsk State Medical University

Email: narkevichart@gmail.com
ORCID iD: 0000-0002-1489-5058
SPIN-code: 9030-1493

MD, Dr. Sci. (Medicine), Assistant Professor

Россия, Chelyabinsk; Krasnoyarsk

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Supplementary files

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2. Fig. 1. Contrast computed tomography urography. 3D reconstruction of the bladder diverticulum.

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3. Fig. 2. Robot-assisted diverticulectomy of the bladder — mobilization of the cervix.

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4. Fig. 3. Robot-assisted diverticulectomy of the bladder — putting the endoloop.

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5. Fig. 4. Robot-assisted diverticulectomy of the bladder — detrusor suturing.

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6. Fig. 5. Robot-assisted diverticulectomy of the bladder — stage of peritoneum sealing.

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Copyright (c) 2023 Kozlov Y.A., Poloyan S.S., Sapukhin E.V., Strashinsky A.S., Makarochkina M.V., Marchuk A.A., Rozhansky A.P., Byrgazov A.A., Muravyov S.A., Narkevich A.N.