Over the past 15 years, pediatric urologists have been utilizing the Da Vinci robotic surgical platform to facilitate minimally invasive surgery in children and infants. While originally adopted as a technology designed for adult patients, the robotic system provides 10-fold magnification, 3-D visualization, and 360-degree instrument rotation, making the system uniquely suited to assist with the reconstructive surgeries specific to pediatric urology. Improvements in technique and equipment have increased not only the indications for robotic surgery, but have also decreased the age limit of eligible patients. Infants as young as one month have benefitted from shorter hospitalization, decreased pain, earlier convalescence, and improved cosmesis.

Dr. Ardavan Akhavan

The Institute for Pediatric Urology at NewYork-Presbyterian Komansky Children’s Hospital of NewYork-Presbyterian/Weill Cornell Medical Center is home to the region’s busiest and most advanced pediatric robotic surgery program. Replete with the newest Da Vinci Xi platform, and led by Ardavan Akhavan, MD, who was recruited three years earlier from the Johns Hopkins Medical Institute, the program has quickly become the most experienced program in the region. Dr. Akhavan has since been routinely performing almost every type of intra-abdominal pediatric urology case robotically in children and infants as young as one month of age.

More Than Just Robotic Pyeloplasty

Procedures include:

• Infant pyeloplasty
• Ureterocalicostomy
• Outpatient extravesical ureteral reimplantation
• Mega-ureteral tapering
• Bladder diverticulectomy
• Ureteroureterostomy
• Nephrectomy
• Heminephrectomy
• Mullerian remnant excision
• Pyelolithotomy
• Bladder neck reconstruction
• Appendicovesicostomy

After having performed hundreds of pediatric robotic surgeries, Dr. Akhavan has become one of the country’s most experienced pediatric robotic surgeons. “This is a very exciting time. We have been able to build a rare, state-of-the-art program offering the robotic option for almost any child and infant requiring abdominal urological surgery,” says Dr. Akhavan. “The difference in recovery is striking: Most children do not require narcotics after surgery.” Active research is aimed at critically evaluating outcomes and participation in multi-institutional collaborations to further advance the role of robotics in pediatric surgrey and improve patient care.