V06-06 SINGLE PORT DA VINCI URETEROILEAL CONDUIT REVISION

Abstract

You have accessJournal of UrologyCME1 Apr 2023V06-06 SINGLE PORT DA VINCI URETEROILEAL CONDUIT REVISION Rogerio Huang, Akhil Saji, Mubashir Billah, Daniel Bassily, Benjamin Rudnick, Michael Stifelman, and Mutahar Ahmed Rogerio HuangRogerio Huang More articles by this author , Akhil SajiAkhil Saji More articles by this author , Mubashir BillahMubashir Billah More articles by this author , Daniel BassilyDaniel Bassily More articles by this author , Benjamin RudnickBenjamin Rudnick More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , and Mutahar AhmedMutahar Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003274.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In the United States, 80,000 new cases of bladder cancer are diagnosed every year. 30% are muscle invasive at the time of diagnosis, requiring radical cystectomy and ileal conduit being the most common type of urinary diversion. A rare complication is a ureteroileal anastomotic stricture (UIS), which occurs in 2-3% of cases. The gold standard treatment is an open repair. The advent of laparoscopy and robotics has allowed these revisions to be done with improved morbidity. In 2018, the single port robotic system has further enabled advances in minimally invasive surgery. There remains a paucity of educational videos on how to perform single port surgery. We aim to demonstrate a single port ureteroileal conduit revision. METHODS: An IRB approval was obtained at our institution and prospective data was collected on all patients undergoing a single port robotic UIS revision from January 2019 - April 2022. This case demonstration involves a 74 year old male who had a radical cystectomy with ileal conduit in June 2021. He subsequently developed bilateral UIS and elected for a single port UIS revision. RESULTS: The total operative time was 155 minutes and estimated blood loss was 25 mL. The patient’s pain was well controlled and his length of stay was 24 hours. There were no postoperative complications. The patient’s pfannenstiel incision healed with excellent cosmetic results. A renal ultrasound done at 3 months showed resolution of hydronephrosis. In a preliminary review, a single surgeon at our institution performed 6 single port UIS revisions. The mean OR time was 152.4 minutes and the mean estimated blood loss was 30.8 mL. The mean length of stay was 2.2 days. The 30-day postoperative complication rate was 0%. CONCLUSIONS: The single port Da Vinci robotic UIS revision is a novel and effective technique. The single port robot offers a superior platform to access tight spaces and excellent precision for dissection and ureteral anastomotic suturing. A single Pfannenstiel incision site allows easy access to the conduit as well as improved cosmesis. Single site surgery can significantly reduce pain and length of stay. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e510 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rogerio Huang More articles by this author Akhil Saji More articles by this author Mubashir Billah More articles by this author Daniel Bassily More articles by this author Benjamin Rudnick More articles by this author Michael Stifelman More articles by this author Mutahar Ahmed More articles by this author Expand All Advertisement PDF downloadLoading ...