V10-11 Customized Robotic Repair of Transplant Ureteric Stricture: Surgical Tips & Tricks and Common Pitfalls

You have accessJournal of UrologyLower Tract Reconstruction (Including Transgender) I (V10)1 May 2024V10-11 CUSTOMIZED ROBOTIC REPAIR OF TRANSPLANT URETERIC STRICTURE: SURGICAL TIPS & TRICKS AND COMMON PITFALLS Mohamed Eltemamy, Hafiz Umair Siddiqui, Nicolas Soputro, Khaled Refaai, Yi-Chia Lin, Venkatesh Krishnamurthi, and Alvin Wee Mohamed EltemamyMohamed Eltemamy , Hafiz Umair SiddiquiHafiz Umair Siddiqui , Nicolas SoputroNicolas Soputro , Khaled RefaaiKhaled Refaai , Yi-Chia LinYi-Chia Lin , Venkatesh KrishnamurthiVenkatesh Krishnamurthi , and Alvin WeeAlvin Wee View All Author Informationhttps://doi.org/10.1097/01.JU.0001009392.30237.90.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteric stricture following kidney transplantation is a serious complication associated with morbidity and potential detrimental effect to the allograft function. Surgical repair is usually needed. This video sought to demonstrate the surgical techniques involved in the repair of transplant ureteric stricture using the robotic platform. METHODS: In this video, we present a case of a 19 year old male who was noted to have a distal transplant ureteric stricture following lower abdominal pain and hydronephrosis. Surgical repair of the transplant ureteric stricture was performed using the DaVinci Xi robotic platform with the patient positioned supine with a slight Trendelenburg tilt. Surgical ports were placed in a similar configuration used for robotic radical prostatectomy. The bladder was dropped and the ureter was dissected. Indocyanine Green (ICG) was injected through a nephrostomy tube to aid in identifying the ureter. The ureteric stricture was then excised till a healthy ureter was encountered. The ureter was then spatulated and re-implanted into the bladder using interrupted 4-0 Vicryl suture. RESULTS: The procedure was successfully completed in 141 minutes without any need for conversion or intraoperative complication. The estimated intraoperative blood loss was 10 mL. The patient was discharged after 1 day, without post-operative complications or readmission. The procedure was replicated in 3 more patients. In case of anastomotic tension, a bladder hitch can be added. In case of shorter ureters, alternative options include a Boari flap reconstruction or the use of the native ipsilateral ureter. In our case series of 7 patients with transplant ureteric strictures, all patients were rendered nephrostomy and stent free after a customized robotic approach. CONCLUSIONS: The robotic platform offers a versatile safe means of performing surgical repairs for transplant ureteric strictures. The specific approach should be tailored to every patient to ensure a favorable outcome. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e829 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mohamed Eltemamy More articles by this author Hafiz Umair Siddiqui More articles by this author Nicolas Soputro More articles by this author Khaled Refaai More articles by this author Yi-Chia Lin More articles by this author Venkatesh Krishnamurthi More articles by this author Alvin Wee More articles by this author Expand All Advertisement PDF downloadLoading ...