Video: Step-by-Step. Robotic assisted laparoscopic ureteral reimplantation – Extravesical approach
Robot-assisted laparoscopic ureteric reimplantation: extravesical technique
Pankaj P. Dangle 1,*,Anup Shah 2 and Mohan S. Gundeti 3,4
1 Department of Surgery, Division of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
2 Pritzker School of Medicine, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
3 Center for Pediatric Robotic and Minimal Invasive Surgery, Department of Surgery, Division of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
4 Comer Children’s Hospital, Chicago, IL, USA
Objectives
To describe our standardised approach to performing robot-assisted extravesical ureteric reimplantation.
Patients and Methods
A total of 29 children, with high grade (III–V) vesico-ureteric reflux (VUR) underwent robot-assisted extravesical ureteric reimplantation between September 2010 and September 2013. Follow-up renal ultrasonography was performed at 1 month and 3 months and a voiding cysto-urethrogram (VCUG) was obtained at 4 months to assess VUR resolution.
Results
The mean (range) patient age at the time of surgery was 5.38 (3.0–10.0) years. Postoperative VCUG showed complete resolution of VUR in 32/40 ureters (80%). Of the remaining refluxing ureters, downgrading of VUR on VCUG was shown in 7/8 ureters (87.5%). The mean (range) length of hospital stay was 1.8 (1–3) days.
Conclusions
In conclusion, robot-assisted extravesical ureteric reimplantation is technically feasible with acceptable resolution of VUR.