Robotic-Assisted Laparoscopic Autotransplantation of the Left Kidney for Extended Iatrogenic Ureteral Injury

Iatrogenic ureteral injury is a rare but serious complication of lower abdominal surgery. In cases of extensive damage, conventional reconstruction may be unfeasible. Autologous kidney transplantation can preserve renal function in selected patients. A 57-year-old patient developed a long-segment left ureteral injury following laparoscopic hysterectomy with bilateral adnexectomy. A nephrostomy had been in place for over one year and was complicated by recurrent infections with progressive deterioration of kidney function. Due to the extent of the injury, direct reconstruction was not possible. Autologous kidney transplantation to the left iliac fossa with ureterocystostomy was performed using a robotic-assisted laparoscopic approach. Both nephrectomy and autotransplantation were completed without intra- or postoperative complications, and long-term kidney function remained stable. Autologous kidney transplantation is an effective option for complex ureteral injuries when conventional reconstruction is not feasible. Robotic assistance allows a safe minimally invasive approach with favorable functional outcomes.