Ureteral Reconstruction using the DaVinci SP Robotic Platform: An Initial Case Series

As medical technology continues to advance, especially visualization and miniaturization, surgical intervention continues to become less invasive. Although initially seen with laparoscopy and multiport robotics, single-site surgery has been the focus for the past decade. Recently, a dedicated single-port operative robotic surgical system, DaVinci SP system, was approved by the Food and Drug Administration. We now report the results of our initial series of ureteral reconstructive procedures using this platform. Three patients underwent robotic ureteral reconstructive procedures using the new single-port robotic system. A 62-year-old man with obstructive uropathy related to benign prostatic hypertrophy, relieved by a transurethral resection of the prostate, underwent bilateral ureteral reimplantation for functional ureteral obstruction. A 37-year-old woman with a history of hysterectomy had right flank pain and was found to have right hydroureteronephrosis down to the level of the right ovarian vein consistent with right ovarian vein syndrome. She underwent right ovarian vein clipping and ureterolysis. A 69-year-old woman with 1 year of right flank pain was found to have a ureteropelvic junction obstruction caused by a short atretic ureteral segment and underwent right pyeloplasty with stent placement. A flexible surgeon controlled suction system was used in the latter two cases. All procedures were completed without conversion to a multiport robotic system, laparoscopy, or open. No major complication or transfusions were required. All patients were discharged to home by postoperative day 2. Ureteral reconstructive procedures can be safely and effectively completed using the SP robotic surgical system. Flexible suction allows for near complete surgeon autonomy.