Single-Surgeon Experience With Robot-Assisted Ureteroneocystostomy for Distal Ureteral Pathologies in Adults.
10.4111/kju.2013.54.8.516
- Author:
Ziho LEE
1
;
Shailen SEHGAL
;
Elton LLUKANI
;
Christopher REILLY
;
Leo DOUMANIAN
;
Jack MYDLO
;
David Inkoo LEE
;
Daniel Dong In EUN
Author Information
1. Division of Urology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
- Publication Type:Original Article
- Keywords:
Minimally invasive surgical procedures;
Reconstructive surgical procedures;
Ureter
- MeSH:
Adult;
Body Mass Index;
Constriction, Pathologic;
Fistula;
Follow-Up Studies;
Humans;
Inflammation;
Intraoperative Complications;
Length of Stay;
Operative Time;
Postoperative Complications;
Reconstructive Surgical Procedures;
Recurrence;
Replantation;
Surgical Procedures, Minimally Invasive;
Ureter;
Vesico-Ureteral Reflux
- From:Korean Journal of Urology
2013;54(8):516-521
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To demonstrate our technical approach for robot-assisted ureteroneocystostomy (R-UNC) for benign and malignant distal ureteral pathologies. MATERIALS AND METHODS: Between January 2009 and January 2013, a total of 10 patients underwent R-UNC in the distal ureter by a single surgeon. Indications for R-UNC were as follows: idiopathic (3), fistula (2), iatrogenic (2), malignancy (2), and chronic vesicoureteral reflux (1). RESULTS: Tension-free anastomosis was attained in all 10 R-UNC procedures. A psoas hitch was performed in 6/10 cases (60%). Intravesical and extravesical reimplantations were completed in 5/10 (50%) and 5/10 cases (50%), respectively. A nonrefluxing ureter was constructed in 2/10 cases (20%). The patients' mean age was 52.9+/-16.6 years, their mean body mass index was 30.8+/-6.3 kg/m2, the mean operative time was 211.7+/-69.3 minutes, mean estimated blood loss was 102.5+/-110.8 mL, and mean length of stay was 2.8+/-2.3 days. There were no intraoperative complications. There was one Clavien-Dindo grade I and one Clavien-Dindo grade II postoperative complication. The mean postoperative follow-up duration was 28.5+/-15.5 months. Two patients had recurrence of ureteral strictures at 3 months postoperatively and were managed successfully with balloon dilation. CONCLUSIONS: Our technique for R-UNC demonstrates good perioperative outcomes. However, underlying periureteral inflammation and pelvic adhesions may predispose patients for stricture recurrence after R-UNC.
