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Flaps and Grafts in Robotic Reconstructive Surgery.

Karen M Doersch1, Kathleen A Li2, Divya Ajay3

  • 1Department of Urology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 656, Rochester, NY 14610, USA. karen_doersch@urmc.rochester.edu.

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Robotic reconstructive urology utilizes flaps and grafts for tissue repair and mesh alternatives. This review details techniques for lower urinary tract reconstruction, enhancing surgical outcomes.

Keywords:
Fistula repairGender-affirming surgeryOmental flapUreteral reconstructionVertical rectus abdominus musculocutaneous flap

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Area of Science:

  • Urology
  • Surgical Reconstruction
  • Robotic Surgery

Background:

  • Flaps and grafts are traditional methods in reconstructive urology for dead space obliteration and mesh alternatives.
  • Robotic surgery offers advantages like reduced pain, enhanced visualization, and improved ergonomics in pelvic procedures.

Purpose of the Study:

  • To provide a comprehensive overview of flaps and grafts used in robotic reconstructive urology for lower urinary tract dysfunction.
  • To serve as a guide for surgeons employing these techniques in robotic procedures.

Main Methods:

  • Literature review of existing studies on flaps and grafts in robotic reconstructive urology.
  • Analysis of reported techniques for tissue interposition and mesh alternatives.

Main Results:

  • Various flaps (omental, peritoneal, VRAM, sigmoid epiploica, gracilis) and grafts (Alloderm™, fascia lata) are utilized.
  • Flaps aid native tissue healing and vascularity; grafts are simpler but depend on recipient site blood supply.
  • Fascia lata is noted as a mesh alternative for robotic sacrocolpopexy.

Conclusions:

  • Robotic reconstructive urology is advancing, with diverse applications for flaps and grafts.
  • Further research is necessary to optimize the use of each flap and graft, aiming for improved outcomes and reduced morbidity.