A Novel Technique of Traction Pre‐Bladder Suturing in Single‐Position Robot‐Assisted Nephroureterectomy: Simplifying the Management of the Intramural Ureter
Case series demonstrates safe intramural ureter excision and bladder closure in early-stage urothelial cancer, suggesting reduced urine leakage during robotic surgery.
Key Points
To evaluate the feasibility and preliminary perioperative outcomes of a traction pre-bladder suturing technique for managing the intramural ureter during single-position robot-assisted laparoscopic nephroureterectomy.
Assessed 10 consecutive patients with early-stage upper tract urothelial carcinoma undergoing surgery between October 2022 and August 2023 with a median 12-month follow-up.
Performed a standardized four-step technique: mucosal tenting, purse-string suture containment, en bloc resection of the protruding mucosa and ureter, and reinforced double-layer bladder closure.
All 10 procedures were completed successfully without conversions or major complications, with a mean operative time of 145 minutes (38 minutes for the intramural ureter) and mean blood loss of 35 mL.
Histopathology confirmed R0 resection of low-grade noninvasive carcinoma in all patients, with two metachronous bladder recurrences identified during the 12-month median follow-up.