V1031 ROBOTIC-ASSISTED LAPAROSCOPIC URETERAL REIMPLANTATION WITH PSOAS HITCH

Abstract

You have accessJournal of UrologyMale Voiding Dysfunction (BPH & Incontinence) & Infection1 Apr 2012V1031 ROBOTIC-ASSISTED LAPAROSCOPIC URETERAL REIMPLANTATION WITH PSOAS HITCH Javier Estébanez, Adolfo Cátedra, Gregorio Garmendia, Cristina Garrido, Itziar Crespo, Miguel Gutierrez, Ione Linazasoro, Jon Belloso, Enrique Artozki, and Juan Sanz Javier EstébanezJavier Estébanez San Sebastian-Donostia, Spain More articles by this author , Adolfo CátedraAdolfo Cátedra San Sebastian-Donostia, Spain More articles by this author , Gregorio GarmendiaGregorio Garmendia San Sebastian-Donostia, Spain More articles by this author , Cristina GarridoCristina Garrido San Sebastian-Donostia, Spain More articles by this author , Itziar CrespoItziar Crespo San Sebastian-Donostia, Spain More articles by this author , Miguel GutierrezMiguel Gutierrez San Sebastian-Donostia, Spain More articles by this author , Ione LinazasoroIone Linazasoro San Sebastian-Donostia, Spain More articles by this author , Jon BellosoJon Belloso San Sebastian-Donostia, Spain More articles by this author , Enrique ArtozkiEnrique Artozki San Sebastian-Donostia, Spain More articles by this author , and Juan SanzJuan Sanz San Sebastian-Donostia, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1135AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present our initial experience in robotic-assisted laparoscopic ureteral reimplantation with psoas hitch. METHODS In this case-study, a 50 year old female patient has been diagnosed with ureteral stenosis after having a hysterectomy. We position the patient supine with a slight trendelenubrg tilt. The camera port is placed 2 cm superior to the umbilicus with two robotic trocars placed laterally. An assistant port is placed in the iliac fossa. We start the procedure with an incision in the posterior parietal peritoneum. We locate the ureter and dissect it at the point of the stenosis. The ureter is clipped and divided. We dissect the anterior and lateral walls of the bladder, ensuring that it can later be anchored to the psoas muscle. The ureter is spatulated. A double J stent is inserted into the ureter through the assistant trocar. We hitch the bladder to the psoas using 3 polyglactin (teen) sutures. An incision is made in the muscular layer of the selected area of the bladder, sparing the mucosa. The superior sutures must include all of the layers of the bladder and ureteral walls. The inferior and lateral sutures must only include the ureter and the bladder mucosa. We complete the reimplantation with several sutures in the bladder muscle, enclosing the ureter between the muscular layer and the mucosa. A drain tube is placed. RESULTS In this case, surgical time was 100 minutes and the hospital stay 4 days. No intra or post-operative complication occurred. CONCLUSIONS Robotic-assisted laparoscopic ureteral reimplantation with psoas hitc is a feasible and reproducible procedure. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e419 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Javier Estébanez San Sebastian-Donostia, Spain More articles by this author Adolfo Cátedra San Sebastian-Donostia, Spain More articles by this author Gregorio Garmendia San Sebastian-Donostia, Spain More articles by this author Cristina Garrido San Sebastian-Donostia, Spain More articles by this author Itziar Crespo San Sebastian-Donostia, Spain More articles by this author Miguel Gutierrez San Sebastian-Donostia, Spain More articles by this author Ione Linazasoro San Sebastian-Donostia, Spain More articles by this author Jon Belloso San Sebastian-Donostia, Spain More articles by this author Enrique Artozki San Sebastian-Donostia, Spain More articles by this author Juan Sanz San Sebastian-Donostia, Spain More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...