Friday, January 04, 2013
First Robotic Assisted Pediatric Urology Surgery in Dade/Broward Performed at Chris Evert Children’s Hospital
Ft. Lauderdale, Fla. – For most children, jumping and running is nothing out of the ordinary. But for four-year-old Emily Herrera, it was a major milestone. On Oct. 25, 2012, Herrera became the first pediatric patient in Dade/Broward counties to undergo robotic assisted pediatric urologic surgery at Chris Evert Children’s Hospital (CECH).
Broward Health Medical Center has used the da Vinci robot for other types of minimally invasive procedures and cardiac surgery. However, this was the first time it was used for a pediatric urology patient.
For more than eight months, Herrera had experienced recurring abdominal pain and vomiting. During this time, Herrera’s mother, Anabel, took her to several physicians to determine the cause of Herrera’s symptoms.
Dr. Miguel Castellan, a pediatric urologist at CECH, examined Herrera, and a retroperitoneal ultrasound showed that Herrera had a duplicated left kidney with hydronephrosis and pelvic dilatation of the lower pole moiety. A MAG 3 renal scan showed an obstruction at the level of the uretero pelvic junction obstruction (UPJ) — a condition that required a surgery known as pyeloplasty to correct. In traditional pyeloplasty, the abdominal muscle is cut and the narrow part of the ureter is surgically removed and then reconnected to the kidney.
Dr. Castellan recommended the da Vinci robotic assisted minimally invasive pyeloplasty to correct the problem. “Robotic assisted pyeloplasty in children provides an equally effective, safe and reasonable efficient way to repair the UPJ,” said Dr. Castellan.
Surgery can be done through small incisions of 0.5 - 0.8 cm, magnified 3D vision and technical dexterity of the da Vinci robot. It allows in situ surgery with increased magnification and dexterity for minimally invasive surgery. By operating through tiny incisions, patients experience less pain, less scarring and fewer complications. Recuperation time is reduced because there is no muscle cutting.
The surgery took place in a surgical suite dedicated for robotic surgeries with assistance from pediatric urologist Dr. Andrew Labbie and robotic surgeon Dr. Vlad Gorbatiy. Dr. Castellan removed the obstruction, then sutured and reconstructed the pelvis with the ureter.
“The surgery was complicated because Emily also had a duplicated system, with a UPJ affecting the lower pole moiety,” said Dr. Castellan. “Most importantly, by performing the surgery, we were able to avoid deterioration of Emily’s kidney function.”
Herrera was able to go home and resume her normal activities within days. “We were very surprised by how quick her recovery time was, and how little scarring she now has,” said her mother. “We have been telling our friends and family that this is the way to go.”
Broward Health, providing service for more than 70 years, is a nationally recognized system offering world class health care services to our neighbors in South Florida. Broward Health includes Broward Health Medical Center, Broward Health North, Broward Health Imperial Point, Broward Health Coral Springs, Chris Evert Children’s Hospital, Broward Health Weston, Broward Health Community Health Services, Broward Health Physician Group and Broward Health Foundation. For more information, visit BrowardHealth.org.