Robot-assisted laparoscopic diverticulectomy with ureteral reimplantation

Abstract

Objective: The objective is to describe our experience with robot-assisted laparoscopic diverticulectomy with extravesical ureteral reimplantation in a pediatric patient.

Methods: A 7-year-old male presented with a symptomatic urinary tract infection secondary to Staphylococcus epidermidis. The patient was found to have a large congenital paraureteral bladder diverticulum on work-up. His options were discussed and he proceeded with robotic diverticulectomy. Intraoperatively, the diverticulum was found to obscure the left ureteral orifice, which necessitated synchronous dismembered extravesical ureteral reimplantation.

Results: Robot-assisted laparoscopic diverticulectomy with extravesical ureteral reimplantation was performed. The procedure time was 283 min, and estimated blood loss was 3 mL. The patient was discharged home on post-operative day 1. He was last seen in clinic six months after surgery and was doing well without any recurrent urinary tract infections.

Conclusion: This video demonstrates a robotic approach for the treatment of complex congenital bladder diverticula. Robotic surgery offers the benefits of good visualization in the pelvis, minimal blood loss, and quick convalescence. Key portions of the diverticulectomy and ureteral reimplantation are clearly illustrated in this video, which can help other surgeons adopt this technique.

Keywords: Bladder diverticulum; Robotic surgery; Ureteral reimplantation.