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Case report: robot-assisted laparoscopic reconstruction of a ureteropelvic junction disruption
David S Yee1, Robert B Klein, Allan M Shanberg
1Department of Urology, Antoci Center for Pediatric Urology & Nephrology, University of California, Irvine, Orange, USA.
Insights
Robot-assisted laparoscopic repair effectively treated a child's traumatic ureteropelvic junction (UPJ) disruption. This minimally invasive approach using the DaVinci system offers a feasible solution for such injuries.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Ureteropelvic junction (UPJ) disruption can occur due to trauma.
- Traditional open repair has been the standard for UPJ disruptions.
- Minimally invasive techniques are increasingly explored for pediatric urological conditions.
Observation:
- An 11-year-old male sustained a UPJ disruption after a motor vehicle accident.
- Initial attempts at retrograde ureteral stenting failed.
- Percutaneous nephrostomy was placed due to associated injuries, preceding definitive repair.
Findings:
- Laparoscopic repair of the traumatic UPJ disruption was performed using the DaVinci robotic system.
- A four-port transperitoneal approach was utilized for the repair.
- Post-repair diuretic renogram at 3 months showed no evidence of obstruction.
Implications:
- Robot-assisted laparoscopic surgery is a viable option for managing traumatic UPJ disruptions in children.
- This minimally invasive technique may offer advantages over open surgery.
- Further studies are warranted to establish long-term outcomes and compare with traditional methods.
Purpose:
We present our experience with robot-assisted laparoscopic repair of a ureteropelvic junction (UPJ) disruption in a child.
Case Report:
An 11-year-old boy was found to have a UPJ disruption after being struck by an automobile. After unsuccessful retrograde ureteral-stent placement, a percutaneous nephrostomy tube was placed for a planned delayed repair because of the patient's multiple injuries. One month later, the patient underwent laparoscopic repair with the DaVinci robotic system using a four-port transperitoneal technique. At 3 months' follow-up, a diuretic renogram demonstrated no obstruction.
Conclusion:
A minimally invasive laparoscopic approach using the DaVinci system is feasible in the repair of a traumatic UPJ disruption.