V01-09 ROBOTIC URETEROURETEROSTOMY OF RETROCAVAL URETER

Abstract

You have accessJournal of UrologyCME1 Apr 2023V01-09 ROBOTIC URETEROURETEROSTOMY OF RETROCAVAL URETER Rainjade Chung, Justin Lee, George W Moran, Miyad Movassaghi, Belinda Li, and Christina P. Carpenter Rainjade ChungRainjade Chung More articles by this author , Justin LeeJustin Lee More articles by this author , George W MoranGeorge W Moran More articles by this author , Miyad MovassaghiMiyad Movassaghi More articles by this author , Belinda LiBelinda Li More articles by this author , and Christina P. CarpenterChristina P. Carpenter More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003221.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retrocaval ureter, also known as “circumcaval ureter” or “preureteral vena cava,” is a relatively rare anatomical variant with an incidence of 0.13% that occurs when the right ureter courses posterior to the vena cava rather than anterior. More commonly seen in males, the etiology is a developmental abnormality of the vena cava, not the ureter. Many cases are clinically silent, but surgical reconstruction is indicated if the patient has severe hydronephrosis, significant functional obstruction, or pain. This patient presented with right flank pain, severe hydronephrosis, and a characteristic "S sign" on retrograde pyelogram (Figure 1). Our objective was to describe our approach to an uncommon case, robotic ureteroureterostomy of a retrocaval ureter. METHODS: The patient was placed in the left lateral decubitus position. The Da Vinci Xi system was utilized and 4 ports were placed in a linear fashion at the lateral border of the rectus 6 cm apart. A 5 mm AirSeal was placed between the 2nd and 3rd arm. ProGrasp Forceps are used in the 1st arm, Maryland bipolar forceps are used in the 2nd arm, and a monopolar curved scissor is used in the 4th arm. Vessel loops were placed on the proximal and distal ureter on either side of the vena cava and were pulled back and forth to allow for visualization and dissection (Figure 2). RESULTS: Successful robotic ureteroureterostomy of a retrocaval ureter. CONCLUSIONS: Robotic ureteroureterostomy is a minimally invasive procedure to manage ureteropelvic junction obstruction caused by a retrocaval ureter. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e82 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rainjade Chung More articles by this author Justin Lee More articles by this author George W Moran More articles by this author Miyad Movassaghi More articles by this author Belinda Li More articles by this author Christina P. Carpenter More articles by this author Expand All Advertisement PDF downloadLoading ...