V06-11 Contralateral Single-Port Robotic Kidney Autotransplantation in a Patient With Ipsilateral Nutcracker and May-Thurner Syndrome

You have accessJournal of UrologyMisc. Benign/ Transplant/ Renovascular (V06)1 May 2024V06-11 CONTRALATERAL SINGLE-PORT ROBOTIC KIDNEY AUTOTRANSPLANTATION IN A PATIENT WITH IPSILATERAL NUTCRACKER AND MAY-THURNER SYNDROME Nicolas A. Soputro, Carter Mikesell, Roxana Ramos-Carpinteyro, Adriana M. Pedraza, Jaya S. Chavali, Ali A. Khalifeh, Mohamed Eltemamy, and Jihad Kaouk Nicolas A. SoputroNicolas A. Soputro , Carter MikesellCarter Mikesell , Roxana Ramos-CarpinteyroRoxana Ramos-Carpinteyro , Adriana M. PedrazaAdriana M. Pedraza , Jaya S. ChavaliJaya S. Chavali , Ali A. KhalifehAli A. Khalifeh , Mohamed EltemamyMohamed Eltemamy , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001010048.21113.99.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Following its introduction in 2018, the purpose-built Single-Port (SP) robotic platform has been increasingly utilized for various urological procedures, including for ipsilateral robotic kidney autotransplantation (R-KAT). With the expanding clinical indications of SP procedures, this video sought to provide a technical description pertaining to a contralateral SP R-KAT through the same incision in a 23-year-old female with concomitant Nutcracker syndrome and May-Thurner syndrome. METHODS: With the patient positioned in a modified lateral decubitus position, a 5 cm transumbilical incision was made to accommodate the purpose-built SP Access Kit. The robot was subsequently docked at an acute angle towards the left kidney. The surgical steps for the nephrectomy were in accordance with the previously described technique for donor nephrectomy. Extracorporeal preparation included flushing with Euro-Collins solution, preparation of the renal vasculature for anastomosis, as well as placement of ureteral stent. Following which, the patient was positioned supine and the robot was re-docked using the same transumbilical incision. Adequate exposure of the contralateral right external iliac vessels was then achieved. Under warm ischemia, the renal vein and artery were subsequently anastomosed in an end-to-side fashion using a 6-0 Gore-Tex suture to the external iliac vein and artery, respectively. The procedure was completed with a ureteroneocystostomy using a modified Lich-Gregoir technique. RESULTS: The procedure was successfully completed without the need for conversion or additional ports. The total robotic console time was 4 hours and 28 minutes with a vascular anastomosis time of 50 minutes. The estimated intraoperative blood loss was 30 mL and there was no intraoperative complication. Vascular stapler used for the ligation of renal artery and vein can be inserted through the laparoscopic assistant port that was also used for insufflation. On postoperative review, the patient reported a complete resolution of her chronic left flank pain without any postoperative complication and readmission within 30 days of surgery. CONCLUSIONS: Contralateral SP R-KAT can be safely performed using the purpose-built SP robotic platform through the same incision without requiring any additional port and whilst maintaining satisfactory postoperative outcomes. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e379 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nicolas A. Soputro More articles by this author Carter Mikesell More articles by this author Roxana Ramos-Carpinteyro More articles by this author Adriana M. Pedraza More articles by this author Jaya S. Chavali More articles by this author Ali A. Khalifeh More articles by this author Mohamed Eltemamy More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...