TY  - EJOU
AU  - Xu, Alex J. 
AU  - Lin, Jeffery S. 
AU  - Chen, Po Yen 
AU  - Carbunaru, Samuel 
AU  - Lee, Yeonsoo S. 
AU  - Zhao, Lee C. 

TI  - Single-port robotic laparoscopic ureterocalicostomy: surgical technique and clinical outcomes
T2  - Canadian Journal of Urology

PY  - 2024
VL  - 31
IS  - 6
SN  - 1488-5581

AB  - <b>Introduction:</b> We describe a method of robotic
ureterocalicostomy (RALUC) with the Da Vinci Single
Port (SP) platform and present clinical outcomes in our
cohort of patients.<br/>
<b>Materials and methods:</b> We retrospectively reviewed
all patients undergoing RALUC with the SP platform in
a single-institution, IRB-approved database between 2020
2023. Demographics, preoperative, intraoperative, and
postoperative outcomes were collated. Surgical success was
defined as freedom from hardware, avoidance of additional
surgical reconstruction, and no obstruction on follow up
imaging/ureteroscopy.<br/>
An incision is made 1/3rd the distance from anterior
superior iliac spine to the umbilicus. The retroperitoneal
space is entered and SP Access Port is placed. The psoas is
identified and concomitant ureteroscopy is used to identify the ureter. The ureter is dissected to the most proximal
aspect and transected. The remaining proximal ureteral
stump is suture ligated. The lower pole parenchyma is
removed to access the calyx. Absorbable barbed suture
is used to control parenchymal bleeding and evert the
mucosal edge of the calyx. Barbed suture is then used for
the ureterocaliceal anastomosis over a ureteral stent.<br/>
<b>Results:</b> Six patients underwent RALUC. Retroperitoneal
approach was used for 5/6 cases. Prior ureteral surgery
had been performed in 4/6 patients. Fifty percent of cases
included an additional procedure with a median operative
time of 248 minutes. One patient required nephrostomy
tube placement postoperatively. Median follow up was
10.35 months with surgical success rate of 67%.<br/>
<b>Conclusions:</b> SP RALUC is a safe and feasible option
for proximal ureteral reconstruction in patients with
unfavorable upper urinary tract anatomy or in salvage
cases.
KW  - reconstruction
KW  -  ureterocalicostomy
KW  -  ureteral reconstruction
KW  -  robotics
KW  -  pyeloplasty

DO  -