Reconstructive urology, traditionally limited to the lower urinary tract, is now increasingly performed on the upper urinary tract, with better‐defined standard outcomes[
1]. Robotic surgery in urology has expanded beyond oncologic applications, such as prostatectomy, to include pediatrics, urinary diversion, and reconstruction. The field's leading edge is now the combination of robotic approaches in ureteral reconstructive surgery[
2]. Walasek et al[
3]. continue to push these boundaries, describing a single‐port approach to robotic ureteral reconstruction. As the authors state, single‐port robotics offers the advantage of requiring a smaller working space, which is particularly beneficial for patients with prior surgery and extensive scarring in or near the surgical field. Their paper details a retroperitoneal approach for ureteral surgery, noting that most patients have not undergone prior retroperitoneal surgery, leaving this cavity free of adhesions and scarring. The authors provide a systematic approach to the surgery, describing step‐by‐step their preferred patient positioning, incision, surgical access, and initial approach. They also discuss adjuncts to enhance the surgery, such as concurrent ureteroscopy, indocyanine green, and near‐infrared fluorescent imaging, which enable real‐time visualization of the ureter and surrounding structures. This technique description paper offers a comprehensive “how‐to” guide on various types of ureteral reconstruction surgeries. The authors sequentially describe procedures ranging from simpler ones, like ureteroneocystostomy, to the most complex, like ureterocalycostomy. They also cover adjuncts to reconstruction, such as buccal mucosa graft ureteroplasty and appendiceal onlay ureteroplasty. As robotic surgery becomes more standard in urology and is used for increasingly advanced procedures, fundamental technical papers like this one are timely additions to the literature and serve as valuable references in the field.
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