You have accessJournal of UrologyUpper-Tract Reconstruction (V05)1 Apr 2020V05-03 ROBOTIC URETEROCALICOSTOMY: TIPS AND TRICKS Jonathan Schmidt*, James Steward, Jay Sulek, Kevin Heinsimer, and Chandru Sundaram Jonathan Schmidt*Jonathan Schmidt* More articles by this author , James StewardJames Steward More articles by this author , Jay SulekJay Sulek More articles by this author , Kevin HeinsimerKevin Heinsimer More articles by this author , and Chandru SundaramChandru Sundaram More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000874.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureterocalicostomy is a well-described but rarely-performed operation for the treatment of complicated ureteropelvic junction (UPJ) strictures, particularly in the settings of a completely intrarenal pelvis, horseshoe kidney, or failed pyeloplasty. In this video, we demonstrate a robotic-assisted laparoscopic approach to this procedure, while highlighting key steps and offering recommendations on surgical technique. METHODS: A robotic-assisted laparoscopic ureterocalicostomy was performed in a 43 year old female for a complicated, symptomatic UPJ obstruction at our academic institution. Informed consent was obtained for the procedure and for the use of images and video. Preoperative workup included a retrograde pyelogram and CT urogram demonstrating a UPJ stricture, completely intrarenal pelvis, dilated lower pole calyx, and thinning lower pole parenchyma. A radionucleotide renal scan demonstrated a right split function of 42.3% and left split function of 57.7%. T1/2 max on the right was 27.1 minutes and 10.8 on the left. The da Vinci surgical system was used to perform the procedure. Each critical step of the procedure was demonstrated and narrated with a focus on surgical technique. Patient follow up was 6 months. RESULTS: We demonstrate the successful creation of the ureterocalicostomy highlighting critical steps of the operation. These include retrograde pyelogram and ureteral stent placement, kidney parenchyma and hilum exposure, ureteral exposure and transection, closure of the UPJ, clamping, excision of the lower pole of the kidney, and the uretero-calyceal anastomosis. The stent was removed at 1 month. At 3 months a renal ultrasound demonstrated lower pole calcyceal enlargement but overall resolved hydronephrosis. The patient reported resolution of pain at 6 months. CONCLUSIONS: This video demonstrates the utility and feasibility of a minimally-invasive ureterocalicostomy for the adult patient and provides detailed recommendations on surgical technique. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e470-e470 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Schmidt* More articles by this author James Steward More articles by this author Jay Sulek More articles by this author Kevin Heinsimer More articles by this author Chandru Sundaram More articles by this author Expand All Advertisement PDF downloadLoading ...