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Video: Step-by-Step. Robotic assisted laparoscopic ureteral reimplantation – Extravesical approach

Robot-assisted laparoscopic ureteric reimplantation: extravesical technique

Pankaj P. Dangle 1,*,Anup Shah 2 and Mohan S. Gundeti 3,4

1 Department of Surgery, Division of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

2 Pritzker School of Medicine, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

3 Center for Pediatric Robotic and Minimal Invasive Surgery, Department of Surgery, Division of Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

4 Comer Children’s Hospital, Chicago, IL, USA

Objectives

To describe our standardised approach to performing robot-assisted extravesical ureteric reimplantation.

Patients and Methods

A total of 29 children, with high grade (III–V) vesico-ureteric reflux (VUR) underwent robot-assisted extravesical ureteric reimplantation between September 2010 and September 2013. Follow-up renal ultrasonography was performed at 1 month and 3 months and a voiding cysto-urethrogram (VCUG) was obtained at 4 months to assess VUR resolution.

Results

The mean (range) patient age at the time of surgery was 5.38 (3.0–10.0) years. Postoperative VCUG showed complete resolution of VUR in 32/40 ureters (80%). Of the remaining refluxing ureters, downgrading of VUR on VCUG was shown in 7/8 ureters (87.5%). The mean (range) length of hospital stay was 1.8 (1–3) days.

Conclusions

In conclusion, robot-assisted extravesical ureteric reimplantation is technically feasible with acceptable resolution of VUR.

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