A case of retrocaval ureter with robot-assisted ureteral reconstruction

Abstract

Introduction: Retrocaval ureter is a rare congenital anomaly that causes ureteral obstruction. Because of the rarity of retrocaval ureter, only a few cases of open, laparoscopic, or robot-assisted surgery have been reported. We herein report a case of retrocaval ureter that was successfully reconstructed with robot-assisted surgery.

Case presentation: A 24-year-old woman was incidentally diagnosed with right hydronephrosis on ultrasonography. Computed tomography revealed retrocaval ureter, and the right hydronephrosis was attributed to the retrocaval ureter. The patient underwent robot-assisted right ureteral reconstruction in the left lateral decubitus position. No intraoperative or postoperative complications occurred, and no right hydronephrosis was observed 6 months after the operation.

Conclusion: The present case demonstrated the feasibility and efficacy of robot-assisted ureteral reconstruction for retrocaval ureter.

Keywords: hydronephrosis; retrocaval ureter; robotic surgery; robot‐assisted ureteral reconstruction; ureteroureteral anastomosis.

Fig. 1

Contrast‐enhanced computed tomography revealed right hydronephrosis and dilatation of the upper right ureter. In addition, part of the right ureter was suspected to be positioned posterior to the inferior vena cava and to detour from the medial to lateral aspect of the inferior vena cava (yellow allow). (a) Coronal plane. (b) Axial plane. *Same site as the intraoperative findings.

Fig. 2

Schema of port placement.

Fig. 3

Intraoperative findings. (a) Before reconstruction. The right ureter was positioned behind the IVC and descended medially to the IVC. (b) After reconstruction. After repositioning the ureter to run anterior to the IVC, ureteroureteral anastomosis was performed with 4‐0 Vicryl®. IVC, inferior vena cava. *Same site as the computed tomography findings.