Abstract

Introduction: Minimally invasive urologic surgery employs extracorporeal, endoscopic and laparoscopic techniques. Robotic assistance has significantly modified urologic laparoscopic surgery in the last decade. This technology is available at the Hospital de Especialidades Eugenio Espejo (HEEE) in the city of Quito - Ecuador, since November 2021, being one of the few public hospitals in Latin America that provides this service to the community. Methods: Observational, retrospective and descriptive study, with case series design. All patients undergoing robotic surgery in the Urology Department of the HEE between November 2021 and March 2023 were included. Results: In the 28 months of the study, 98 surgical procedures were performed. Of the 91 adult patients, 67% were men. The main preoperative diagnoses were malignant prostate tumor, malignant kidney tumor, hydronephrosis, adrenal tumor, malignant bladder tumor and lithiasis. The procedures performed were radical prostatectomy, nephrectomy, ureterolysis and adrenalectomy. The mean operative time was 169.2±66.3 min; with a Dokin time of 12.7±5.2 min. There were 1.1% of non-fatal complications. The median hospital stay was 4 days (range 2 to 18 days). In the 7 younger patients with a mean age of 8.3 years operated on, the most common procedure was ureteral reimplantation. There were two cases of non-fatal complications. Surgical time was 255.7±29.2 min and Dokin time was 9.5±5.3 min. Conclusion: In the Hospital de Especialidades Eugenio Espejo, urological robotic surgery has been used mainly for the surgical treatment of neoplasias in adults and urinary tract alterations in children, being the experience for other procedures still incipient. Surgical times have been longer in children due to the complexity of reconstructive surgeries, but with excellent results and early recovery.

Keywords

surgery, endoscopy, hospital