Minimally invasive ileal ureter replacement: Comparative analysis of robot‐assisted laparoscopic versus conventional laparoscopic surgery

Abstract

Background This study is an initial comparative analysis of perioperative and intermediate‐term functional outcomes between patients who underwent robot‐assisted laparoscopic (RALS) or conventional laparoscopic surgery (LS). Materials and Methods A total of 25 patients who underwent ileal ureter replacement (10 RALS and 15 LS) were followed by functional cine magnetic resonance urography (MRU) combined with a modified Whitaker test. Also, the characteristics, perioperative data and functional outcomes of the patients were compared. Results The estimated blood loss, postoperative hospital stay and time to oral intake were significantly lower in the RALS group. At the median 14‐month follow‐up, all the patients showed improved renal function and were symptom‐free, with no signs of leakage or stenosis observed by cine MRU combined with a modified Whitaker test. Conclusions RALS with an extracorporeal bowel resection is feasible and appears to be safe, with quick postoperative recovery and encouraging outcomes.

Ileal ureteral replacement for the management of ureteral avulsion during ureteroscopic lithotripsy: a case series

“…A longer ureteral defect can be replaced using a segment of the intestines, usually the ileum (ileal interposition graft), in our department [7]. The first ileal ureter substitution was reported by Goodwin et al [21].…”

“…Open ileal ureteral substitution has some disadvantages, including greater trauma, longer recovery, and more complications. At present, minimally invasive techniques are often chosen, including laparoscopic surgery and robotic surgery [7,23], which have lower narcotic requirements, shorter hospital stays, and shorter times to convalescence. According to Table 1, mean operative time as shorter for MIS group.…”

“…The ileal ureter substitution was similar to that described in our previous study [7]. After general anesthesia, the patient was placed in the oblique position (45° from horizontal) with the lesion side up.…”

“…Ileal ureteric replacement is a reliable solution for complex urinary reconstruction [6]. Open ileal ureteral substitution is a traditional surgical method, and it has gradually been replaced by minimally invasive surgery (MIS) in the clinic, including laparoscopic (LS) or robotic-assisted surgery (RAS) [7]. Currently, there is no consensus about the optimal surgical approach for the management of UA because of ureteroscopic lithotripsy.…”

A ureteral stricture disease score and classification system: correlation with upper urinary tract reconstructive surgery complexity

“…Because we were trying to develop a convenient and efficient descriptive system of scoring and classification, and our previous statistical analysis showed that the patient's age, gender, and BMI have little effect on the complexity of the operation, we did not include these variables because we did not want a system that was cumbersome and difficult to calculate. Prior to the development of the scoring and classification system, we conducted an extensive review of studies to identify candidate variables that are clinically useful and have been shown to independently influence surgical decisions (6,(13)(14)(15).…”