Objective To report the described case of retrocaval ureter treated for the first time with robot-assisted ureteroplasty with Hugo RAS system. Patient and surgical procedure A 36-year-old man presented with acute right flank pain and underwent contrast-enhanced abdominal CT scan, which revealed right hydronephrosis due to retrocaval ureter in the lumbar region. The patient was counselled for robot-assisted ureteroplasty. Following the incision of the Told’s fascia, the colon was mobilized. The inferior vena cava (IVC) served as the anatomical landmark for identifying and dissecting the ureter, which was traced posterior to the IVC, revealing dilatation of the renal pelvis and proximal ureter. The retrocaval segment of the ureter was completely detached from the IVC and resected near the ureteropelvic junction. The distal ureter was preserved and translocated anteriorly to the IVC. Anastomosis was initiated on the posterior surface using a continuous 3/0 monofilament suture and completed over a double-J stent with a separate suture of the same type Results No intraoperative complications were recorded. Console time was 55 min. The estimated blood loss was <50 mL. The patient was discharged on the second postoperative day and the double-J stent was removed after four weeks. Conclusions This is the first reported case of robot-assisted ureteroplasty for a retrocaval right ureter treated using the Hugo RAS System. We detailed the proper trocar placement and provided a step-by-step description of this delicate surgery. Our experience may be of interest to centres utilizing novel robotic platforms to perform complex procedures for congenital ureteral anomalies.
Noya-Mourullo et al. (Fri,) studied this question.