ESPU Congress 2018 - Abstract Book

206 29 th CONGRESS OF THE ESPU CONCLUSIONS The laparoscopic approach is safe and feasible for these patients, with all the advantages of laparoscopy. VD-15 (VS without presentation) ROBOT ASSISTED LAPAROSCOPIC ADRENALECTOMY (RALA) IN A MORBIDLY OBESE CHILD WITH CUSHING'S SYNDROME Aparajita MITRA  1 , Rajiv PADANKATTI  1 , Vijay Mahantesh SAMALAD  1 , Thirumalai GANESAN  2 , Vasantharoopan C  3 and Venkat SRIPATHI  1 1) Apollo Children's Hospital, Pediatric Urology, Chennai, INDIA - 2) Apollo Hospitals, Urology, Chennai, INDIA - 3) Apollo Hospitals, Anesthesiology, Chennai, INDIA PURPOSE Adrenalectomy in a patient with Cushing's syndrome is fraught with problems and can be a surgical and anesthetic nightmare. We describe a robotic approach to a left adrenalectomy with emphasis on patient positioning, port placement and dissection technique. MATERIAL AND METHODS A morbidly obese (BMI >35) 13 year old girl presented with hypertension and hyperglycaemia. Endocrine and radiologic workup revealed a left adrenal adenoma. RALA was planned after physiological optimization. It was especially beneficial for this child where an open or conventional laparoscopic surgery would have been extremely difficult owing to a thick panniculus and increased visceral adiposity. RESULTS The console time was 100 minutes with minimal blood loss. Post-operative recovery was rapid although a prolonged hospital stay was necessary to observe the trend in blood pressure and for glycemic control. There was a weight loss of 2.5 kg, significant improvement in mobility and mood and a decrease in mean arterial blood pressure. The insulin requirement could be tapered and gradually discontinued. Serum Cortisol decreased from 30 to 17. CONCLUSIONS RALA should be the procedure of choice in a morbidly obese child with multiple co-moribidities. As this is an uncommon condition, this report, we believe will be a valuable technical guide. VD-16 (VS without presentation) ROBOTIC URETERO-CALICOSTOMY AFTER FAILED PYELOPLASTY Dario Guido MINOLI, Alfredo BERRETTINI, Mirella MOGIATTI, Erika Adalgisa DE MARCO and Gianantonio MANZONI Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Pediatric Urology, Milan, ITALY PURPOSE In this video we report the robotic approach to a complex case of persistent pyelo-ureteral obstruc- tion finally solved with uretero-calicostomy. MATERIAL AND METHODS A 14 year-old-girl with right flank pain has been diagnosed with a pyelo-ureteral obstruction and underwent a standard robotic pyeloplasty in 2013.