V13-10 Robotic Single-Port Transperineal Urethroplasty With Buccal Mucosa Graft

You have accessJournal of UrologyLower Tract Reconstruction (including Transgender) II (V13)1 May 2024V13-10 ROBOTIC SINGLE-PORT TRANSPERINEAL URETHROPLASTY WITH BUCCAL MUCOSA GRAFT Charan S. Mohan, Rohan Sawhney, Zorawar Singh, Maya Srinath, Justin Han, and Arun Rai Charan S. MohanCharan S. Mohan , Rohan SawhneyRohan Sawhney , Zorawar SinghZorawar Singh , Maya SrinathMaya Srinath , Justin HanJustin Han , and Arun RaiArun Rai View All Author Informationhttps://doi.org/10.1097/01.JU.0001009532.52598.9a.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Open transperineal urethroplasty has traditionally been difficult amongst morbidly obese patients (BMI≥45) and has shown to have higher rates of complications including recurrent strictures, long term failure, and higher blood loss. Morbidly obese patients often have long skin to urethra distance, further complicating urethral repair. We are introducing a novel transperineal urethroplasty approach utilizing buccal mucosa for obese patients utilizing the daVinci Single Port (SP) Robotic Surgical System. METHODS: A 37-year-old morbidly obese male (BMI of 54) with CKD Stage IV and diabetes mellitus presented to the office for evaluation of a recurrent 4 cm bulbar urethral stricture after prior failed stricture repairs. Due to stricture length, location, and co-morbidities, patient elected to undergo robotic SP transperineal urethroplasty with buccal mucosa graft. The SP system was air-docked to the perineum using the SP Access Port kit allowing for surgical access to the urethra. Buccal mucosa was harvested to perform a ventral onlay urethroplasty using the SP system. RESULTS: Total operative time was 187 min. The patient had no immediate postoperative issues and was discharged on postoperative day 1. He underwent a successful voiding trial in clinic 3 weeks later. Retrograde urethrogram at the time of follow up confirmed resolution of the stricture. At 30-days following surgery, he was not readmitted nor had any other complications. CONCLUSIONS: SP robotic transperineal urethroplasty with buccal mucosa graft is a safe and successful technique for proximal urethral stricture repair, particularly in morbidly obese patients. Adaptations of this technique can be employed for other difficult cases in lower urinary tract reconstruction. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1158 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Charan S. Mohan More articles by this author Rohan Sawhney More articles by this author Zorawar Singh More articles by this author Maya Srinath More articles by this author Justin Han More articles by this author Arun Rai More articles by this author Expand All Advertisement PDF downloadLoading ...