Introduction: We aim to report our technique and functional and radiological outcomes of extra peritoneal robotic pediatric pyeloplasty through a mini-pfannenstiel (3cm) incision using da-Vinci single-port (SP) robotic surgical system in pediatric population. Methods: We present our initial series of 8 pediatric patients that underwent robotic SP pyeloplasty between 2020 - 2022. The case presented in current video is 1 year old male with known history antenatal hydronephrosis that presented with worsening postnatal hydronephrosis and renal function on split function and renal ultrasound imaging studies. The patient underwent cystoscopy, stent placement that confirmed severe ureteropelvic junction (UPJ) obstruction prior to proceeding with robotic surgery. He was placed in relaxed lateral position, extra peritoneal space was developed through mini pfannenstiel incision before docking the SP surgical system. The following robotic surgical steps were described: (1) development of extra peritoneal space, (2) identification of ureter and ureteropelvic junction, (3) dismemberment and reduction of redundant renal pelvis, (4) ureteropelvic junction anastomosis using running 5-0 Vicryl sutures. Results: Overall operative time was 120 minutes and associated with minimal blood loss. No complications and patient discharged on POD1 and stent removed in 4 weeks as outpatient. The attached tables describe our study patient demographics, indications (Table 1) and outcomes among our study population (Table 2). All patients tolerated the surgery with minimal postsurgical pain and no narcotic requirement. Conclusions: Single port extra peritoneal pyeloplasty is a safe and feasible option for upper tract reconstruction in pediatric patients. All patients had complete resolution of symptoms both clinically and based on imaging upon follow up. SOURCE OF Funding: None
