A new technique for ureteral resection to prevent urine dissemination and cancer seeding.

Abstract

We describe a case in which robot-assisted radical ureterectomy was performed for residual ureteral recurrence in a postoperative patient with renal pelvis cancer. A 75-year-old woman underwent laparoscopic radical nephroureterectomy for left renal pelvic cancer at another hospital. During follow-up, a papillary tumor was found in the bladder on cystoscopy, and a continuous tumor was found in the residual ureter on computed tomography. Robot-assisted radical ureterectomy was performed in combination with transurethral resection of bladder tumors. To avoid urine spillage, bladder cuff excision was performed using a mechanical suture device while monitoring the interior of the bladder. We developed a new technique for remnant ureteral resection using cystoscopy and a vascular stapler to prevent urine dissemination and cancer seeding.