Minimizing variability: Standardized approach to retroperitoneal single‐port robot‐assisted ureteral reconstruction

Abstract

Evidence suggests that robot‐assisted ureteroplasty is a safe and feasible management option of ureteral strictures. The retroperitoneal approach to ureteral reconstruction using single‐port (SP) robot can be beneficial in challenging cases of patients with prior history of abdominopelvic surgery or radiation. Herein, we present a standardized approach to retroperitoneal SP robot‐assisted ureteral reconstruction, highlighting the advantages of this technique in selected clinical scenarios.

Keywords

clinical outcome / robotic surgery / robotic ureteroplasty / retroperitoneal ureteral reconstruction / single‐port (SP) robot

References

[1] Lee M , Lee Z , Houston N , Strauss D , Lee R , Asghar AM , et al. Robotic ureteral reconstruction for recurrent strictures after prior failed management. BJUI Compass. 2023 May; 4 (3): 298- 304.

[2] Fifer GL , Raynor MC , Selph P , Woods ME , Wallen EM , Viprakasit DP , et al. Robotic ureteral reconstruction distal to the ureteropelvic junction: a large single institution clinical series with short-term follow up. J Endourol. 2014 Dec; 28 (12): 1424- 8.

[3] Chammas, Jr. MF , Mitre AI , Hubert N , Egrot C , Hubert J . Robotic laparoscopic pyeloplasty. J Soc Laparoendosc Surg. 2014 Jan–Mar; 18 (1): 110- 5.

[4] Lee Z , Lee M , Lee R , Koster H , Cheng N , Siev M , et al. Ureteral rest is associated with improved outcomes in patients undergoing robotic ureteral reconstruction of proximal and middle ureteral strictures. Urology. 2021 Jun; 152: 160- 6.

[5] Slawin J , Patel NH , Lee Z , Dy GW , Kim D , Asghar A , et al. Ureteral reimplantation via robotic nontransecting side-to-side anastomosis for distal ureteral stricture. J Endourol. 2020 Aug; 34 (8): 836- 9.

[6] Asghar AM , Lee Z , Lee RA , Slawin J , Cheng N , Koster H , et al. Robotic ureteral reconstruction in patients with radiation-induced ureteral strictures: experience from the collaborative of reconstructive robotic ureteral surgery. J Endourol. 2021 Feb; 35 (2): 144- 50.

[7] Lee M , Lee Z , Strauss D , Jun MS , Koster H , Asghar AM , et al. Multi-institutional experience comparing outcomes of adult patients undergoing secondary versus primary robotic pyeloplasty. Urology. 2020 Nov; 145: 275- 80.

[8] Do M , Kallidonis P , Qazi H , Liatsikos E , Ho Thi P , Dietel A , et al. Robot-assisted technique for Boari flap ureteral reimplantation: is robot assistance beneficial? J Endourol. 2014 Jun; 28 (6): 679- 85.

[9] Corse TD , Dayan L , Cheng N , Brown A , Krishnan N , Mishra K , et al. A multi-institutional experience utilizing boari flap in robotic urinary reconstruction. J Endourol. 2023 Jul; 37 (7): 775- 80.

[10] Fuller TW , Daily AM , Buckley JC . Robotic ureteral reconstruction. Urol Clin North Am. 2022 Aug; 49 (3): 495- 505.

[11] Bowsher WG , Shah PJR , Costello AJ , Tiptaft RC , Paris AMI , Blandy JP . A critical appraisal of the Boari flap. Br J Urol. 1982 Dec; 54 (6): 682- 5.

[12] Schimpf MO , Wagner JR . Case report: robot-assisted laparoscopic Boari flap ureteral reimplantation. J Endourol. 2008 Dec; 22 (12): 2691- 4.

[13] Lee NG , Corbett ST , Cobb K , Bailey GC , Burns AS , Peters CA . Bi-Institutional comparison of robot-assisted laparoscopic versus open ureteroureterostomy in the pediatric population. J Endourol. 2015; Nov; 29 (11): 1237- 41.

[14] Maestroni U , Dinale F , Ziglioli F , Bocchialini T , Guarino GG , Campobasso D . Robotic transposition and ureteroureterostomy of type 1 retrocaval ureter. J Surg Case Rep. 2023 Jun; 2023 (6): rjad352.

[15] Eisenberg ML , Lee KL , Zumrutbas AE , Meng MV , Freise CE , Stoller ML . Long-term outcomes and late complications of laparoscopic nephrectomy with renal autotransplantation. J Urol. 2008 Jan; 179 (1): 240- 3.

[16] Koch MO , McDougal WS . The pathophysiology of hyperchloremic metabolic acidosis after urinary diversion through intestinal segments. Surgery. 1985 Sept; 98 (3): 561- 70.

[17] Naude JH . Buccal mucosal grafts in the treatment of ureteric lesions. BJU Int. 1999 May; 83 (7): 751- 4.

[18] Ahangar P , Mills SJ , Smith LE , Gronthos S , Cowin AJ . Human gingival fibroblast secretome accelerates wound healing through anti-inflammatory and pro-angiogenic mechanisms. NPJ Regen Med. 2020 Dec 10; 5 (1): 24.

[19] Zhao LC , Yamaguchi Y , Bryk DJ , Adelstein SA , Stifelman MD . Robot-Assisted Ureteral Reconstruction Using Buccal Mucosa. Urology. 2015 Sep; 86 (3): 634- 8.

[20] Zhao LC , Weinberg AC , Lee Z , Ferretti MJ , Koo HP , Metro MJ , et al. Robotic ureteral reconstruction using buccal mucosa grafts: a multi-institutional experience. Eur Urol. 2018 Mar; 73 (3): 419- 26.

[21] Lee Z , Lee M , Koster H , Lee R , Cheng N , Jun M , et al. A multi-institutional experience with robotic ureteroplasty with buccal mucosa graft: an updated analysis of intermediate-term outcomes. Urology. 2021 Jan; 147: 306- 10.

[22] Yang CH , Lin YS , Weng WC , Lu CH , Hsu CY , Tung MC , et al. Validation of robotic-assisted ureteroplasty with buccal mucosa graft for stricture at the proximal and middle ureters: the first comparative study. Journal of Robotic Surgery. 2022 Oct; 16 (5): 1009- 17.

[23] Melnikoff A . Sur le replacement de I'uretere par anse isolee de l'intestine grele. Rev Clin Urol. 1912; 1: 601- 3.

[24] Reggio E , Richstone L , Okeke Z , Kavoussi LR . Laparoscopic ureteroplasty using on-lay appendix graft. Urology. 2009 Apr; 73 (4): 928.e7- 928.e10.

[25] Cheng S , Fan S , Wang J , Xiong S , Li X , Xu Y , et al. Laparoscopic and robotic ureteroplasty using onlay flap or graft for the management of long proximal or middle ureteral strictures: our experience and strategy. Int Urol Nephrol. 2021 Mar; 53 (3): 479- 88.

[26] Wang J , Li Z , Fan S , Xiong S , Yuan C , Meng C , et al. Robotic ureteroplasty with appendiceal onlay flap: an update on the outcomes of 18-month follow-up. Transl Androl Urol. 2022 Jan; 11 (1): 20- 9.

[27] Mufarrij PW , Woods M , Shah OD , Palese MA , Berger AD , Thomas R , et al. Robotic dismembered pyeloplasty: a 6-year, multi-institutional experience. J Urol. 2008 Oct; 180 (4): 1391- 6.

[28] Gupta NP , Nayyar R , Hemal AK , Mukherjee S , Kumar R , Dogra PN . Outcome analysis of robotic pyeloplasty: a large single-centre experience. BJU Int. 2010 Apr; 105 (7): 980- 3.

[29] Billah MS , Stifelman M , Munver R , Tsui J , Lovallo G , Ahmed M . Single port robotic assisted reconstructive urologic surgery—with the da Vinci SP surgical system. Transl Androl Urol. 2020 Apr; 9 (2): 870- 8.

[30] Mufarrij PW , Shah OD , Berger AD , Stifelman MD . Robotic reconstruction of the upper urinary tract. J Urol. 2007 Nov; 178 (5): 2002- 5.

[31] Chhabra JS , Balaji Sudharsan S , Singh A , Mishra S , Ganpule A , Sabnis R , et al. Robot-assisted ureterocalycostomy: a single centre contemporary experience in adults. Arab J Urol. 2016 Mar; 14 (1): 25- 30.

[32] Casale P , Mucksavage P , Resnick M , Kim SS . Robotic ureterocalicostomy in the pediatric population. J Urol. 2008 Dec; 180 (6): 2643- 8.

[33] So WZ , Tiong HY . Robotic-assisted laparoscopic ureterocalicostomy for persistent uretero-pelvic junction (UPJ) obstruction after failed renal pyeloplasty. Eur Urol Open Sci. 2022; 37: 1- 2.

[34] Mittal S , Aghababian A , Eftekharzadeh S , Saxena S , Janssen K , Lombardo A , et al. Robot-assisted laparoscopic ureterocalicostomy in the setting of ureteropelvic junction obstruction: a multi-institutional cohort. J Urol. 2022 Jul; 208 (1): 180- 5.

RIGHTS & PERMISSIONS

The Authors. UroPrecision published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.