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Robot-assisted laparoscopic ileal ureter
Joseph R Wagner1, Megan O Schimpf, Jeffrey L Cohen
1Department of Urology, Hartford Hospital/University of Connecticut, Hartford, Connecticut, USA.
Background And Objectives:
A patient with a solitary kidney, cysteine stones, and recurrent ureteral strictures underwent robot-assisted laparoscopic ureterectomy with ileal ureter formation.
Methods:
Using a transperitoneal, 4-port robotic approach, we removed the strictured ureter and created an ileal ureter. The ileal-pyelo and ileal-vesical anastomoses were performed using the robotic system. An extracorporeal bowel anastomosis was performed using stapling devices. Operative time was 9 hours with negligible blood loss, and the patient was discharged after 5 days.
Results:
A cystogram at 10 days demonstrated patent anastomoses without extravasation. The patient continues to do well 48 months later.
Conclusion:
Robot-assisted laparoscopic ileal ureter replacement is feasible with excellent long-term outcome.