Laparoscopic and Robotic Reconstruction of the Upper Genitourinary Tract

Abstract

Reconstructive surgery of the upper urinary tract has historically been performed as an open surgical operation. Reasons for this included a combination of previously insufficient laparoscopic equipment and the mastering of a skill set with a steep learning curve (i.e., intracorporal suturing). As laparoscopic technology has advanced, and perhaps even more significantly with the addition of robotic assistance, minimally invasive approaches in upper tract urologic reconstruction have increased in scope. Currently, even uncommon and challenging reconstructive cases are being performed in a minimally invasive manner. This chapter seeks to discuss some of the less common minimally invasive reconstructive surgeries being performed by providing a detailed description of each in combination with a list of necessary equipment. Specific topics covered include distal ureteral reconstruction (ureteroneocystostomy, psoas hitch, Boari flap), ureteroneocystostomy, retrocaval ureter, and nephropexy. A brief review of the literature is also covered where applicable.