V09-09 SINGLE PORT ROBOTIC URETERONEOCYSTOSTOMY: A VERSATILE APPROACH FOR URETERAL RECONSTRUCTION

Abstract

You have accessJournal of UrologyCME1 Apr 2023V09-09 SINGLE PORT ROBOTIC URETERONEOCYSTOSTOMY: A VERSATILE APPROACH FOR URETERAL RECONSTRUCTION Zeyad Schwen, Ethan Ferguson, Mahmoud Abou Zeinab, Jaya Sai Chavali, Roxana Ramos, Alp Tuna Beksac, Mohamed Eltemamy, and Jihad Kaouk Zeyad SchwenZeyad Schwen More articles by this author , Ethan FergusonEthan Ferguson More articles by this author , Mahmoud Abou ZeinabMahmoud Abou Zeinab More articles by this author , Jaya Sai ChavaliJaya Sai Chavali More articles by this author , Roxana RamosRoxana Ramos More articles by this author , Alp Tuna BeksacAlp Tuna Beksac More articles by this author , Mohamed EltemamyMohamed Eltemamy More articles by this author , and Jihad KaoukJihad Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003317.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minimally invasive and robotic distal ureteral reconstruction has significantly reduced the perioperative morbidity associated with robotic ureteral reimplantation. We present our initial series of single-port (SP) robotic ureteral reimplantation which aims to demonstrate the feasibility of the approach and versatility of the SP platform as well as the favorable perioperative morbidity. METHODS: Inclusion indications for 14 consecutive patients included various benign and malignant conditions including ectopic ureter, distal ureteral stricture, bladder diverticula, renal autotransplantation, and distal ureterectomy for upper tract urothelial carcinoma. The primary outcome of this study was demonstration of the feasibility and versatility of the technique for a variety of benign and malignant conditions as well as evaluation of its perioperative morbidity. Patients are placed in the supine position and access is obtained using a floating dock technique. The SP is docked in addition to the robotic scissors, Maryland bipolar, and cadiere grasper. Following mobilization of the ureter, the bladder is freed to facilitate a tension-free anastomosis with or without a psoas hitch. The ureter is spatulated and anastomosed to the bladder dome in a water-tight fashion over a ureteral stent. RESULTS: Patients had a median age of 41 and ASA class of 2 (Table 1). All SP ureteroneocystotomies were performed successfully without any conversions to open (Table 2). Four patients required a psoas hitch. Median anastomosis operative time was 31.5 minutes and a median blood loss of 87.5cc. Hospital length of stay ranged from 1 to 19 days, with a median of 3.5 days, however was 1.5 days when renal autotransplants were excluded. Patients had excellent preservation of renal function at a median follow up of 4.5 months. CONCLUSIONS: We demonstrate the versatility of the SP approach for ureteral reimplantation for a variety of benign and malignant conditions. Patients had favorable perioperative morbidity and preservation of renal function at follow up. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e839 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zeyad Schwen More articles by this author Ethan Ferguson More articles by this author Mahmoud Abou Zeinab More articles by this author Jaya Sai Chavali More articles by this author Roxana Ramos More articles by this author Alp Tuna Beksac More articles by this author Mohamed Eltemamy More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...