Introduction: For patients who require intermittent catheterization, emptying of the bladder sometimes cannot be accomplished via the urethra due to a lack of dexterity in those with spinal cord abnormalities or intact sensation in children with posterior urethral valves. Creation of a continent catheterizable stoma provides alternative and efficient mean of emptying the bladder. Traditionally, open surgery is required to accomplish this. The recent development of the robotic system has allowed for the Mitrofanoff procedure to be done less invasively. In this video, we present our techniques and outcomes in performing robotic-assisted laparoscopic Mitrofanoff procedure in children who requires intermittent catheterization.

Methods: In this video, we illustrate the technique in performing this procedure. We also describes several maneuvers that allow the procedure to be done efficiently and in a timely manner.

Results: We performed the procedure on five patients. The mean follow-up time was 19.2 months. None of the patients had any complications. One patient required an injection of the bulking agent for minor stomal incontinence. The average surgical time decreased from 400 minutes during the first few cases to 200-250 minutes in the later cases.

Conclusion: We found that robotic-assisted laparoscopic Mitrofanoff procedure can be performed safely and efficaciously. With experience, the surgical time approaches that of open surgery. This procedure done laparoscopically has advantages over traditional open method including less post-operative pain and morbidity and more rapid recovery.