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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">urovest</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник урологии</journal-title><trans-title-group xml:lang="en"><trans-title>Urology Herald</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2308-6424</issn><publisher><publisher-name>Rostov State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21886/2308-6424-2025-13-2-47-54</article-id><article-id custom-type="elpub" pub-id-type="custom">urovest-1054</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Первый российский опыт робот-ассистированной лапароскопической пластики лоханочно-мочеточникового сегмента у детей на роботической системе da Vinci Xi</article-title><trans-title-group xml:lang="en"><trans-title>Robot-assisted laparoscopic ureteropelvic junction plasty in children using the da Vinci Xi robotic system: a Russian first experience</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9145-8671</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сизонов</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sizonov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Валентинович Сизонов — д-р мед. наук, профессор </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>Vladimir V. Sizonov — Dr.Sci.(Med.); Full Prof. </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">vsizonov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9311-3706</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макаров</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Makarov</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Алексей Геннадьевич Макаров — канд. мед. наук  </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>Alexey G. Makarov — Cand.Sc.(Med) </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">lexxrgmu@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6468-5983</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пакус</surname><given-names>С. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Pakus</surname><given-names>S. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сергей Михайлович Пакус — канд. мед. наук  </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>Sergei M. Pakus — Cand.Sci.(Med) </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">sergejj.pakus@rambler.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-5349-6353</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кварацхелия</surname><given-names>Д. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kvaratskhelia</surname><given-names>D. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Давид Гиаевич Кварацхелия  </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>David G. Kvaratskheliya </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">dr.davidkv@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-6405-7675</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Владимировна Орлова </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>Elena V. Orlova </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">orlovae1@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-5271-5967</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пискунова</surname><given-names>С. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Piskunova</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Светлана Геннадьевна Пискунова — канд. мед. наук </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>Svetlana G. Piskunova — Сand.Sc.(Med) </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">pgv@odbro.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1710-0169</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коган</surname><given-names>М. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kogan</surname><given-names>M. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Михаил Иосифович Коган — д-р мед. наук, профессор, заслуженный деятель науки РФ  </p><p>Ростов-на-Дону </p></bio><bio xml:lang="en"><p>Mikhail I. Kogan — Dr.Sc.(Med), Full Prof., Hons. Sci. of the Russian Federation </p><p>Rostov-on-Don </p></bio><email xlink:type="simple">dept_kogan@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Областная детская клиническая больница ; Ростовский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Rostov Regional Children's Clinical Hospital ; Rostov State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Клинико-диагностический центр «Здоровье»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>‘Zdorovye’ Clinical and Diagnostic Centre</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Областная детская клиническая больница</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Rostov Regional Children's Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Ростовский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Rostov State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>08</day><month>06</month><year>2025</year></pub-date><volume>13</volume><issue>2</issue><fpage>47</fpage><lpage>54</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сизонов В.В., Макаров А.Г., Пакус С.М., Кварацхелия Д.Г., Орлова Е.В., Пискунова С.Г., Коган М.И., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Сизонов В.В., Макаров А.Г., Пакус С.М., Кварацхелия Д.Г., Орлова Е.В., Пискунова С.Г., Коган М.И.</copyright-holder><copyright-holder xml:lang="en">Sizonov V.V., Makarov A.G., Pakus S.M., Kvaratskhelia D.G., Orlova E.V., Piskunova S.G., Kogan M.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.urovest.ru/jour/article/view/1054">https://www.urovest.ru/jour/article/view/1054</self-uri><abstract><p>Введение. Роботическая пиелопластика — наиболее частое хирургическое вмешательство, выполняемое в мире с использованием роботической платформы da Vinci у детей. Нами представлен первый опыт выполнения робот-ассистированной лапароскопической пиелопластики (РАЛП) с использованием системы da Vinci Xi.Цель исследования. Провести анализ опыта выполнения РАЛП у детей с использованием роботической платформы da Vinci Xi.Материалы и методы. В период с июля по октябрь 2024 года выполнено 14 РАЛП. Среди больных было 7 (50%) мальчиков и 7 (50%) девочек. Средний рост пациентов составил 131,2 ± 22,1 см, средняя масса тела — 29,7 ± 15,0 кг. У 11 (78,5%) пациентов имел место гидронефроз 3-й степени по SFU, у 3 (21,5%) — гидронефроз 4-й степени. Внутренняя причина обструкции пиело-уретерального сегмента (ОПУС) выявлена у 6 (43%) пациентов, внешняя причина («конфликтный» сосуд) — у 8 (57%) пациентов. Всем пациентам была выполнена робот-ассистированная расчленяющая пиелопластика без редукционной резекции лоханки. Операцию выполняли в положении на противоположном по отношению к обструкции боку. Доступ осуществляли, установив три 8-мм троакара для введения оптики и роботических инструментов и одного 5-мм — для введения инструментов ассистентом.Результаты. В серии случаев конверсий не было. Общее время оперативного вмешательства на начальных этапах составляло 195 минут, на настоящий момент время, затраченное на выполнение операции, сократилось до 110 минут. Средняя продолжительность операции составила 146,7 ± 29,3 минуты. Время докинга на начальных этапах составляло 60 минут, затем по мере освоения сократилось в среднем до 25,0 ± 10,8 минуты. Консольное время составляло на начальных этапах 150 минут, на настоящий момент тайминг сократился до 70 минут. Среднее консольное время операции при внутренних причинах ОПУС составило 82,0 ± 16,0 минуты, при внешних причинах — 93,0 ± 27,0 минуты. В послеоперационном периоде у одного пациента отмечалась дисфункция стента, которая была устранена без замены стента.Заключение. Начальный опыт РАЛП демонстрирует в качестве преимущества по сравнению с лапароскопической пиелопластикой (ЛП) сохранение физических кондиций оператора на всём протяжении формирования анастомоза, позволяющих формировать анастомоз максимально прецизионно, избегая компромисса между желаемым качеством наложения интракорпорального шва и реальным результатом на фоне неизбежной физической усталости оператора при использовании лапароскопического доступа. Текущие результаты позволяют предположить, что приобретённый нами двадцатилетний опыт в ЛП заметно ускоряет процесс освоения роботической платформы, оптимизируя продолжительность консольного времени и в кратчайшие сроки выйти на плато консольного времени.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. Robotic pyeloplasty represents the most frequently performed surgical intervention globally utilizing the da Vinci robotic platform in pediatric patients. The present study introduces the initial experience of executing robot-assisted laparoscopic pyeloplasty (RALP) employing the da Vinci Xi robotic system.Objective. To conduct a comprehensive analysis of the experience in performing RALP in pediatric patients using the da Vinci Xi robotic platform. Materials &amp; methods. Between July and October 2024, a total of 14 robot-assisted laparoscopic pyeloplasties (RALP) were successfully performed. The patient cohort consisted of an equal distribution of 7 boys (50%) and 7 girls (50%). The mean anthropometric parameters of the patients were as follows: height 131.2 ± 22.1 cm and body weight 29.7 ± 15.0 kg. The severity of hydronephrosis, assessed using the Society for Fetal Urology (SFU) grading system, revealed that 11 patients (78.5%) presented with SFU grade 3 hydronephrosis, while 3 patients (21.5%) exhibited SFU grade 4 hydronephrosis. The etiology of the ureteropelvic junction obstruction (UPJO) was determined as follows: an UPJO internal cause was identified in 6 patients (43%), whereas an external cause (‘conflict’ vessel) was detected in 8 patients (57%).All patients underwent robot-assisted dissecting pyeloplasty without reduction resection of the renal pelvis. The surgical procedure was executed with the patient positioned on the side contralateral to the site of obstruction. The laparoscopic access was established using three 8 mm trocars for the insertion of optics and robotic instruments, complemented by a single 5 mm trocar for the assistant’s instrumentation.Results. No conversions were observed throughout the case series. The operative time demonstrated a significant reduction over the study period: initially, the total operative time was 195 min, which decreased to 110 min by the study’s conclusion. The mean operative time across all cases was 146.7 ± 29.3 min. The docking time exhibited a notable learning curve, decreasing from 60 minutes during the initial stages to an average of 25.0 ± 10.8 min as proficiency improved. Similarly, the console time reduced from 150 min initially to 70 min by the study’s end. The mean console time varied based on the etiology of obstruction: for internal causes of OPUS, it was 82.0 ± 16.0 min, while for external causes, it was 93.0 ± 27.0 min. Postoperatively, only one patient experienced stent dysfunction, which was successfully managed without the need for stent replacement.Conclusions. The initial experience with RALP reveals a significant advantage over conventional laparoscopic pyeloplasty (LP). Specifically, RALP allows for the preservation of the operator’s physical conditioning throughout the entire process of anastomosis formation. This preservation enables the formation of an anastomosis with maximum precision, thereby eliminating the compromise between the desired quality of intracorporeal suturing and the actual surgical outcome that often occurs due to operator fatigue with laparoscopic access. The current findings indicate that our accumulated two decades of experience in laparoscopic pyeloplasty substantially speeds up mastering the robotic platform. This prior expertise facilitates the optimization of console time duration and enables the rapid attainment of the performance plateau, achieving optimal surgical efficiency in the shortest possible timeframe.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>дети</kwd><kwd>гидронефроз</kwd><kwd>обструкция пиелоуретерального сегмента</kwd><kwd>роботическая пиелопластика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>children</kwd><kwd>hydronephrosis</kwd><kwd>ureteropelvic junction obstruction</kwd><kwd>robotic pyeloplasty</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Peters CA. Complications in pediatric urological laparoscopy: results of a survey. J Urol. 1996;155(3):1070-1073. PMID: 8583567</mixed-citation><mixed-citation xml:lang="en">Peters CA. Complications in pediatric urological laparoscopy: results of a survey. J Urol. 1996;155(3):1070-1073. 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