Robotic pediatric urology.

The minimally invasive surgery using robotic assistance is evolving fast in the field of pediatric urology. The freedom afforded by these surgical actuators is real and here to stay. The da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA) provides delicate manipulation, coalesced with three-dimensional visualization and a superior magnification. It has bridged the gap between laparoscopy and open surgery. Nonetheless, it should be made clear that in case of robotic malfunction laparoscopic skills are of paramount importance. Robotic pediatric urologic procedures such as pyeloplasty, ureteral reimplantation, partial or total nephrectomy with or without ureteral stump removal are now done on a regular basis at select centers offering robotic expertise. Reconstructive surgeries such as appendico-vesicostomy can be performed, however, such complex surgeries are still in their infancy.