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Case Reports
. 2008 Jul-Sep;12(3):306-9.

Robot-assisted laparoscopic ileal ureter

Joseph R Wagner  1 , Megan O Schimpf, Jeffrey L Cohen
Affiliations
Case Reports

Robot-assisted laparoscopic ileal ureter

Joseph R Wagner et al. JSLS. 2008 Jul-Sep.

Abstract

Background and objectives: A patient with a solitary kidney, cysteine stones, and recurrent ureteral strictures underwent robot-assisted laparoscopic ureterectomy with ileal ureter formation.

Methods: Using a transperitoneal, 4-port robotic approach, we removed the strictured ureter and created an ileal ureter. The ileal-pyelo and ileal-vesical anastomoses were performed using the robotic system. An extracorporeal bowel anastomosis was performed using stapling devices. Operative time was 9 hours with negligible blood loss, and the patient was discharged after 5 days.

Results: A cystogram at 10 days demonstrated patent anastomoses without extravasation. The patient continues to do well 48 months later.

Conclusion: Robot-assisted laparoscopic ileal ureter replacement is feasible with excellent long-term outcome.

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Figures

Figure 1.
Figure 1.
Port placement for robotic ileal ureter creation: A 12-mm trocar was placed at the umbilicus with a Hasson technique (H). Three 8-mm robotic trocars were placed (1,2,3) as depicted.
Figure 2.
Figure 2.
Two 10-mm Jackson-Pratt drains are placed through the 8-mm robotic ports 1 and 3.
Figure 3.
Figure 3.
Postoperative cystogram confirming patent anastomoses with no extravasation.
See this image and copyright information in PMC

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