V1539 ROBOTIC-ASSISTED LAPAROSCOPIC BOARI FLAP RECONSTRUCTION FOR UNILATERAL URETERAL STRICTURE

Abstract

You have accessJournal of UrologyReconstruction1 Apr 2010V1539 ROBOTIC-ASSISTED LAPAROSCOPIC BOARI FLAP RECONSTRUCTION FOR UNILATERAL URETERAL STRICTURE Jonah Marshall, Dana Schie, Hani Rashid, and Guan Wu Jonah MarshallJonah Marshall More articles by this author , Dana SchieDana Schie More articles by this author , Hani RashidHani Rashid More articles by this author , and Guan WuGuan Wu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1291AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Boari flap is frequently used for repair of long distal/mid ureteral strictures. In this video, we show a complicated case of unilateral distal/mid ureteral strictures managed with Boari flap using a robotic-assisted laparoscopic approach. METHODS The patient is a 37-year-old female who developed a right mid ureteral stricture after aorta-to-femoral bypass surgery. She subsequently underwent an open right ureteroureterostomy. However, the primary repair failed leading to frequent right flank pain, UTIs, sepsis and nephrostomy tube placement. She was transferred to our medical center. After thorough evaluation, the patient elected to have Boari flap reconstruction. The patient was placed supine with a slight Trendelenburg position. A total of 6 ports were placed in a fan distribution in the patient's upper abdomen. Extensive lysis of adhesions was required. Right ureteral lysis was performed and the bladder mobilized. A Boari flap was created and tubularized over a 12-French red rubber catheter and anastomosed to the mid ureter. A 7-French double J ureteral stent was placed. The entire procedure was done robotically with the da Vinci S system RESULTS Operative time was approximately 4 1/2 hours. Estimated blood loss was 250 ml. Postoperative course was uneventful and the length of hospital stay was 3 days. The Foley catheter was removed on POD# 15 and the ureteral stent was removed 5 weeks after surgery. At her 12-month followup, CT urogram with delayed images showed no hydronephrosis or obstruction and her kidney function remained normal. CONCLUSIONS A robotic-assisted laparoscopic Boari flap reconstruction for unilateral distal/mid ureteral strictures is a feasible alternative to open surgery. The robotic surgical system provides us a platform to perform complex reconstruction of the urinary tract laparoscopically. Rochester, NY© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e593-e594 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonah Marshall More articles by this author Dana Schie More articles by this author Hani Rashid More articles by this author Guan Wu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...