Robot-assisted laparoscopic megaureter tapering with ureteral reimplantation: Tips and tricks. 2017

Belinda Li, and Bruce W Lindgren, and Dennis B Liu, and Edward M Gong
Department of Urology, Loyola University Medical Center, Maywood, IL, USA.

OBJECTIVE The aim was to demonstrate surgical techniques used in pediatric robot-assisted laparoscopic megaureter tapering (RALMT) with ureteral reimplantation. We report on our preliminary experience. METHODS We reviewed video of patients who underwent RALMT with ureteral reimplantation between August 2012 and November 2015. MT was performed extravesically and ureteral reimplantation was performed by extravesical detrusorrhaphy with ureteral anchoring. All patients had an intraoperatively placed ureteral stent. RESULTS Between August 2012 and November 2015, 14 patients underwent RALMT with ureteral reimplantation. Highlighted techniques include variations in ureteral stent insertion, method of excisional tapering, and approach to reimplantation. All (10/10) patients with postoperative ultrasounds following ureteral stent removal demonstrated radiographic improvement at a mean follow-up of 9 months. No patients had postoperative febrile urinary tract infections. The only complication was one patient with postoperative ileus. CONCLUSIONS We demonstrate variations in surgical techniques which may facilitate the surgical steps of RALMT with ureteral reimplantation. Our preliminary experience suggests the procedure is safe and feasible for pediatric patients with symptomatic megaureter.

UI MeSH Term Description Entries
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D012092 Replantation Restoration of an organ or other structure to its original site. Reimplantation,Surgical Replantation,Replantation, Surgical,Reimplantations,Replantations,Replantations, Surgical,Surgical Replantations
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004108 Dilatation, Pathologic The condition of an anatomical structure's being dilated beyond normal dimensions. Ectasia,Dilatation, Pathological,Dilatations, Pathologic,Dilatations, Pathological,Pathologic Dilatation,Pathologic Dilatations,Pathological Dilatation,Pathological Dilatations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013520 Urologic Surgical Procedures Surgery performed on the urinary tract or its parts in the male or female. For surgery of the male genitalia, UROLOGIC SURGICAL PROCEDURES, MALE is available. Procedure, Urologic Surgical,Procedures, Urologic Surgical,Surgical Procedure, Urologic,Surgical Procedures, Urologic,Urologic Surgical Procedure,Urological Surgical Procedures,Procedure, Urological Surgical,Procedures, Urological Surgical,Surgical Procedure, Urological,Surgical Procedures, Urological,Urological Surgical Procedure
D014513 Ureter One of a pair of thick-walled tubes that transports urine from the KIDNEY PELVIS to the URINARY BLADDER. Ureters
D014515 Ureteral Diseases Pathological processes involving the URETERS. Disease, Ureteral,Diseases, Ureteral,Ureteral Disease
D065287 Robotic Surgical Procedures Surgical procedures performed remotely using a computer that controls surgical instruments attached to mechanical arms designed to perform the tasks of the surgeon. Robot Surgery,Robot-Assisted Surgery,Robot-Enhanced Procedures,Robot-Enhanced Surgery,Robotic-Assisted Surgery,Surgical Procedures, Robotic,Procedure, Robot-Enhanced,Procedure, Robotic Surgical,Procedures, Robotic Surgical,Robot Assisted Surgery,Robot Enhanced Procedures,Robot Enhanced Surgery,Robot Surgeries,Robot-Assisted Surgeries,Robot-Enhanced Procedure,Robot-Enhanced Surgeries,Robotic Assisted Surgery,Robotic Surgical Procedure,Robotic-Assisted Surgeries,Surgery, Robot,Surgery, Robot-Assisted,Surgery, Robot-Enhanced,Surgery, Robotic-Assisted,Surgical Procedure, Robotic

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