Robotic-Assisted Surgery in Urology

da Vinci® robotic surgery system

The da Vinci® robotic surgery system can be used to treat any number of urologic conditions, as well as certain structural defects of the reproductive system.

Robotic-assisted laparoscopic surgery in urology is one of the field’s most exciting advances in the past decade. This laparoscopic technology uses a combination of highly magnified 3-D imagery and surgeon-guided robotic movements to perform delicate urologic surgeries with unmatched precision. The result: less bleeding, less pain, less scarring and a potentially easier recovery for your child.

Our surgeons at Nemours/Alfred I. duPont Hospital for Children (in Wilmington, Del.), Nemours Children’s Specialty Care, Jacksonville (in Florida), and Nemours Children’s Hospital (in Orlando) use the state-of-the-art da Vinci® robotic surgery system. If your child needs urologic surgery, take comfort in the fact that our highly skilled experts can perform many types of corrective and reconstructive procedures in this minimally invasive way.

Learn More About Robotic-Assisted Laparoscopic Surgery in Urology
How Does the da Vinci® Robotic Surgery System Work?

When it comes to robotic-assisted laparoscopic surgery in urology, da Vinci® technology leads the way. With the da Vinci® robotic surgery system, the surgeon controls precision tools using a camera system. A few tiny incisions (rather than the one larger incision typically required in traditional open procedures) allow the camera system and tools to enter the child’s body. From there, the surgeon can control the surgery while sitting at a nearby computer console. Aided by enhanced 3-D imagery and highly magnified views, the surgeon is able to manipulate the robotic-assisted tools with greater dexterity, stability and range of motion than what can normally be achieved with the human hand.

A common misconception about robotic surgery is that the robot actually replaces your child’s surgeon. This is not the case. The surgeon’s expertise is simply enhanced by the precision technology offered by the da Vinci system. The surgeon is in control at all times, and the robot does not move on its own.

What Are the Benefits?

The potential benefits of robotic-assisted surgery in urology are many. Pediatric patients typically experience:

  • smaller incisions
  • less postoperative pain
  • decreased blood loss and need for transfusions
  • lower risk of infection
  • shorter hospital stays
  • quicker return to daily activities
  • less scarring and improved cosmetic appearance

Surveys show that parents whose children underwent robotic-assisted surgery as opposed to traditional open surgery were overwhelmingly pleased with the outcome, particularly with the size and appearance of the scars.

Types of Robotic-Assisted Surgical Procedures

The da Vinci® robotic surgery system can be used to treat any number of urologic conditions, as well as certain structural defects of the reproductive system. Many of these conditions are congenital (they occurred during fetal development and were present at birth), but a few can be acquired later on.

Some of the surgeries we perform include:

ACE procedure: Antegrade colonic enema (or “ACE”) surgery involves creating a small channel to the colon with the appendix. Fluid inserted into this channel can flush the bowel of feces.

Mitrofanoff: Some children have conditions that require intermittent drainage of their bladder with a small tube. Surgery to create a channel to the bladder can be done by using the appendix and bringing it out of the belly button.

Nephrectomy (or partial nephrectomy): This is an operation to remove a kidney (or part of a kidney) that isn’t functioning properly or is diseased.

Partial cystectomy: This is an operation to remove part of the bladder.

Pyeloplasty: This is the removal of a urinary blockage, most frequently a ureteropelvic junction (or “UPJ”) obstruction, which is usually caused by a narrowing of the ureter (the tubes that carry urine from the kidney to the bladder) where it connects to the kidney.

Renal cyst ablation: This is an operation to remove cysts (fluid-filled sacs) on the kidney.

Urachal cyst removal: The urachus is the remnant of a channel that connects the top of the bladder to the belly button during fetal development. This typically seals off early in pregnancy. If it doesn’t seal off, the channel may need to be removed.

Ureteral reimplantation: An abnormally developed ureter can cause vesicoureteral reflux (an unhealthy backflow of urine from the bladder back up toward the kidneys). Surgery to reposition the ureter can correct this problem.

Is Robotic-Assisted Laparoscopic Surgery in Urology Right for My Child?

When surgery is needed for your child, we realize that you want all the information possible in order to make the best decision. So we take the time to explain each option, always looking for the least invasive method for faster healing and return to normal activities.

You can also count on us to work closely with you and other medical professionals on your child’s care team, because we firmly believe that a collaborative approach yields the best outcomes. Together, we’ll provide the guidance you need when considering a robotic-assisted approach versus a traditional open surgical procedure for your child.


Nemours Children's Specialty Care, Jacksonville

807 Children’s Way
Jacksonville, FL 32207
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For Appointments: (904) 697-3600

Hours: Monday–Friday, 8 a.m. to 5 p.m.
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What to Bring
  • your photo ID
  • insurance and/or Medicaid cards
  • referral from your referring physician (if required by your insurance)
  • co-payment, if applicable
  • legal guardianship or custody papers if you are not the patient’s parent
If available, please provide:
  • preferred pharmacy contact information
  • names and dosages of all medications your child is taking (including over-the-counter medications)
  • name and number of your primary care physician
  • parent (and child’s) social security numbers
  • parent work information (address, telephone numbers)
  • immigration information (if your child was not born in the United States)
  • list of prior immunizations
New Patients
  • Patient Registration (PDF)
Returning Patients
  • Release of Information (PDF)
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  • Patient Presents Without Legal Guardian (PDF)
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    Note: A parent or legal guardian must be with a child for a first visit.
Forms & Resources
New Patient Forms
  • Patient Registration (PDF)
Returning Patient Forms
  • Release of Information (PDF)
    English | Spanish
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families

Pioneering Pediatric Robotic Surgery in Urology

Pediatric urologists at Nemours Children’s Specialty Care, Jacksonville, consistently named among the “Best Doctors in America,®” are regional leaders in minimally invasive urologic procedures. We routinely perform robotic-assisted laparoscopic surgery in urology at our partner hospital, Wolfson Children’s Hospital. Our reputation for excellence draws families from around the region who are seeking exceptional care for their child’s urological condition.

Our surgeons use the most updated version of the da Vinci® robotic surgery system, which provides 3-D imagery and views at 15-times magnification, allowing for delicate urological surgeries to be performed with smaller instruments and greater precision. This translates into smaller scars, less postoperative pain, decreased risk of infection and faster healing times for our young patients, who are often under 2 years of age.

Our Surgeons

Pediatric urologist Michael Erhard, MD, heads the robotics program at Nemours Children’s Specialty Care, Jacksonville. A leader in his field, Dr. Erhard has earned recognition as a dedicated surgeon and a passionate advocate for his patients.

Our surgical team also understands that children are not simply small adults. Their developing bodies require specialized care, and so do their emotional needs. If your child requires urologic surgery, you’ll find that every expert your child meets — from skilled radiologists and anesthesiologists to knowledgeable nurse practitioners — realize the importance of treating the whole child and not just the illness.

Watch a video about robotic surgery featuring Nemours pediatric urologist, Dr. Michael Erhard.

What to Expect Before Surgery

Before you and your child’s care team make any decisions about surgery, your child may undergo blood tests, urine tests and imaging studies — MRIs, CAT scans or nuclear medicine studies. These tests assess the structure and function of your child’s urinary tract so that we can determine the best course of treatment.

Because many problems of the urinary tract overlap with diseases of the kidney, we often work closely with specialists from nephrology. Our collaborative approach is one of the hallmarks of our care.

About Anesthesia

Parents often have questions about the anesthesia used for surgery. Rest assured that during any urologic procedure that requires anesthesia, our board-certified Nemours pediatric anesthesiologists are experts at determining the best types of medicine to keep your child calm, comfortable and safe.

The Department of Anesthesiology at Nemours Children’s Specialty Care, Jacksonville is based at our partner facility, Wolfson Children’s Hospital. The department includes anesthesiologists and a nursing staff who coordinate pre-procedure evaluations and pain management care. In addition to the experience and talent of our staff, the hospital’s state-of-the-art surgery center is fully equipped and staffed to meet children’s unique needs.

We also offer kid-friendly strategies to help lessen your child’s fears about surgery. One example is the “play therapy” sessions we offer — a great way to help ease any anxiety our young patients may be feeling about their upcoming procedures.

Connecting With Your Child’s Primary Care Physician

We believe that one of the best ways to advance medicine to benefit children is through collaboration. We work closely with physicians in the community to assess their cases, offer expert diagnostics and help connect patients quickly to the right treatment.

NemoursOne, our electronic health record (EHR) is a secure, online environment that connects all phases of care for a child — inpatient, outpatient, at home and at the referring physician's office. Using a special physician portal, primary care and referring physicians can securely access information about the care provided by the Nemours medical team and monitor a child’s progress any time, day or night.