Transplant Ureter Inguinal Herniation Treated by Robotic Inguinal Hernia Repair.

Abstract

We report the case of a transplanted ureter obstructed by an inguinal herniation treated by a robotic-assisted approach. This is a case of a 63-year-old male who had a kidney transplant with a graft on the left pelvis in September 2014, and presented to the clinic for evaluation of bilateral inguinal hernia. On physical examination he had bilateral palpable inguinal hernias, with the right one larger and only partially reducible. Computed tomography scan showed portion of urinary bladder and transplant ureter in the left inguinal hernia and mild hydroureteronephrosis in the transplanted kidney. Patient underwent catheterization of the transplant ureter where indocyanine green was injected for proper transplant ureter identification with the Firefly filter and robotic assisted hernia repair. Surgery was uneventful and patient was discharged home the same day with no further complications. The robotic approach using the Firefly filter was shown to be safe during the dissection to avoid injury to the transplant ureter.