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A Multi-Institutional Experience With Robotic Appendiceal Ureteroplasty.

Min Suk Jun1, Sabrina Stair1, Alex Xu1

  • 1Department of Urology, New York University Grossman School of Medicine at New York University Langone Medical Center, New York, NY.

Urology
|July 19, 2020
PubMed
Summary

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Robotic appendiceal ureteroplasty offers a versatile solution for right ureteral strictures. This multi-institutional study shows a high success rate of 92% in restoring ureteral patency and relieving flank pain.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Reconstructive Surgery

Background:

  • Ureteral strictures can cause significant morbidity, including flank pain and renal damage.
  • Traditional open surgical repair can be associated with substantial morbidity.
  • Appendiceal flap ureteroplasty is an established reconstructive technique.

Purpose of the Study:

  • To evaluate the multi-institutional outcomes of robotic-assisted appendiceal ureteroplasty for right ureteral strictures.
  • To assess the efficacy and safety of this minimally invasive approach.

Main Methods:

  • Retrospective review of 13 patients undergoing robotic appendiceal flap ureteroplasty.
  • Data collected on surgical technique (onlay vs. interposition), stricture characteristics, operative details, and outcomes.

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  • Primary endpoint: surgical success defined by absence of flank pain and ureteral patency.

    • Main Results:

    • High success rate of 92% (11/12 patients) at a mean follow-up of 14.6 months.
    • Mean stricture length was 6.5 cm.
    • Mean operative time was 337 minutes; median length of stay was 2.5 days.
    • Low complication rate (no Clavien-Dindo > 2 within 30 days), with one unrelated perioperative death.

    Conclusions:

    • Robotic appendiceal ureteroplasty is a versatile and effective technique for managing right ureteral strictures.
    • This approach demonstrates high success rates and a favorable safety profile in a multi-institutional setting.