Two Cases of Robot-Assisted Ureteral Reimplant in a Duplicated System

Abstract

Introduction:

We intend to explore operative techniques for repair of a missed ureteral injury in a duplicated system.

Materials and Methods:

The first patient underwent a laparoscopic hysterectomy; the lower pole moiety ureter was seen, and preserved, however, the upper pole moiety was missed, and divided. She presented with a fluid collection, and investigation demonstrated a duplicated system. The second patient was undergoing an open abdominal exploration for endometriosis. It was discovered intraoperatively that she had experienced an injury, however, only the lower pole moiety was repaired. She presented with an abdominal fluid collection, and imaging revealed a duplicated system. Each patient underwent robot-assisted ureteral reimplant.

Results:

Total operative time was 240 and 180 minutes. Robot time was 190 and 150 minutes. Estimated blood loss (EBL) was 25 and 75 mL. There were no intraoperative complications. The second case had postoperative ileus lasting for 5 days. Hospital stay was 1 and 6 days. Postoperative cystogram at 2 weeks showed no extravasation in either case. Retrograde pyelogram and stent removal at 6 weeks showed no stricture and no extravasation.

Conclusions:

Robot-assisted repair of a ureteral injury can safely be performed in a duplicated system.

No competing financial interests exist.

Runtime of video: 7 mins 31 secs