V03-05 ROBOT-ASSISTED LAPAROSCOPIC PYELOPLASTY FOR URETEROPELVIC JUNCTION OBSTRUCTION IN A Y-TYPE DUPLICATED COLLECTING SYSTEM

Abstract

You have accessJournal of UrologyPediatrics (V03)1 Sep 2021V03-05 ROBOT-ASSISTED LAPAROSCOPIC PYELOPLASTY FOR URETEROPELVIC JUNCTION OBSTRUCTION IN A Y-TYPE DUPLICATED COLLECTING SYSTEM Zoe Gan, Katherine Fischer, and Aseem Shukla Zoe GanZoe Gan More articles by this author , Katherine FischerKatherine Fischer More articles by this author , and Aseem ShuklaAseem Shukla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001991.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal duplication anomalies may present with a ureteropelvic junction obstruction (UPJO) affecting the lower moiety. A proximal partial ureteral duplication (Y-type ureter) is a rare associated finding and can render surgical repair more challenging. We present our technique for robot-assisted left lower pole pyeloplasty in the setting of a Y-type ureter demonstrating the anatomical considerations relevant for the adjacent upper pole ureter. METHODS: Cystoscopy and retrograde pyelogram were performed, and an open-ended catheter was placed across the lower pole UPJO for identification. The daVinci® robot platform was docked. The left colon and renal pelvis were mobilized medially to visualize the Y-type duplication and dilated lower pole. The lower pole ureter was dismembered and spatulated past the area of obstruction until unaffected normal ureter was reached. A stent was placed antegrade into the lower pole ureter, the anastomosis between the lower pole ureter and renal pelvis was performed, and excess renal pelvis was trimmed. A feeding tube was passed retrograde to identify and protect the upper pole ureter during the anastamosis, and minor spatulation was performed on the upper pole ureter to avoid compromising the insertion of the upper pole ureter into the renal pelvis. RESULTS: The patient was discharged on postoperative day 1. One month postoperatively, a renal bladder ultrasound showed resolved dilation of the lower pole, and the upper pole remained non-dilated. The stent was removed 2 months postoperatively. CONCLUSIONS: A lower pole UPJO in a Y-type duplex system may be repaired with a modified Anderson Hines dismembered pyeloplasty using a robot surgery platform. Additional consideration is given to maintain the patency and continuity of the adjacent unobstructed ureter. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e223-e223 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zoe Gan More articles by this author Katherine Fischer More articles by this author Aseem Shukla More articles by this author Expand All Advertisement Loading ...