Does a small stent size increase the risk of post-operative complications following reconstructive robotic surgery in the pediatric population?

The use of double J stents (DJS) is common practice during robotic reconstructive surgeries in the pediatric population. Some studies claimed that a small stent diameter is prone to obstruction and migration, thus might increase the number of post-op complications. The aim of this study was to evaluate whether the use of a small stent size leads to higher complication rate following robotic reconstructive surgery in children. We have retrospectively reviewed the medical files of patients, who underwent reconstructive robotic surgery with insertion of 3Fr or 4Fr DJS over a 3-year period, from two medical centers. The data included demographics, operation type, DJS size, post-op complications and duration of hospital stay. The study included 47 patients, 33 (70.2%) were male. The mean age was 34 months (range 3–192 months). 3Fr DJS was used in 13 (27.7%) patients and 4Fr stent was utilized in the remaining 34 (72.3%) children. 3Fr stents were more frequently used in younger children (14 vs 42 months, p < 0.01). There were 3 (6.4%) stent-related post-op complications, two leaks in the 4Fr stent group and one stent migration in the 3Fr group. No statistically significant difference in post-operative complication rate, was found between the two DJS groups (p = 0.631). No correlation was found between DJS size and type of complication (r = 0.238, p = 0.107 for dislodgement; r = − 0.130, p = 0.382 for leaks, respectively). Our data show that the use of small DJS size does not lead to increased post-op complication rate and is safe and durable in pediatric robotic surgery.