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Johns Hopkins Pediatric

A Less Invasive Robotic Approach For Obstructed Kidney Repair

Pediatrician
December 1, 2015

Alyssa Parian, MD

Compared with open pyeloplasty, pediatric surgeon Ardavan Akhavan’s robotic approach can be done with less post-operative analgesia, less scarring, a shorter hospital stay, and a shorter time to return to normal activities.

When 4-year-old kelsey jenkins was diagnosed with a blockage in the space between her ureter and kidney—the ureteropelvic junction—she was given two operative options at Johns Hopkins Children’s Center: an open procedure which requires a long, open-flank incision and a 2-to- 4-night hospital stay, or a minimally invasive laparoscopic approach that requires three small incisions and a 1-night hospital stay. For Kelsey’s mom, Nicole Jenkins, the answer was a no-brainer: “The biggest thing for me was the significantly shorter recovery time.”

Then, serendipitously, Kelsey’s mother learned that a new pediatric urologic surgeon, Ardavan Akhavan, was joining Johns Hopkins and bringing with him a minimally invasive approach with a twist—a robot. Akhavan’s approach, called a robotic pyeloplasty, not only offered all the benefits of the usual laparoscopic procedure, it also had been shown to offer surgeons a greater range of motion and enhanced visualization for more precise dissection and suturing. Studies have shown that compared with open pyeloplasty, the robotic approach can be done with less post-operative analgesia, less scarring, a shorter hospital stay, and a shorter time to return to normal activities.

That was enough for Jenkins, who elected the robotic approach with Akhavan for Kelsey, who underwent the procedure this past August. The result?

“Better than expected,” says Nicole Jenkins. “This was great timing with Dr. Akhavan’s arrival at Johns Hopkins.”

Jenkins was impressed not only with Kelsey’s complication-free outcome, but also with Akhavan’s way of working with families.

“The moment he took my daughter’s case he called us, answered our questions, drew pictures of the procedure for Kelsey, and generally did everything in his power to make sure we understood what was happening with our child,” says Jenkins. “He was above my expectations.”

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