Robot-Assisted Technique for Boari Flap Ureteral Reimplantation: Is Robot Assistance Beneficial?

Do, Minh; Kallidonis, Panagiotis; Qazi, Hasan; Liatsikos, Evangelos; Thi, Phuc Ho; Dietel, Anja; Stolzenburg, Jens‐Uwe

doi:10.1089/end.2013.0775

Cited by 38 publications

(18 citation statements)

References 19 publications

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“…For bilateral injuries, there is scarce evidence comparing open reconstruction and endourological methods such as laparoscopic and robotic ureteral reconstruction. [7][8][9] In particular, there were reports that deemed bilateral ureteric injury as an indication to forgo endourological treatment options and move on to open reconstruction directly. [10] Additionally, this is a salvage repair, which is best managed open, because of the patient's bilateral persistent strictures despite stenting and prior unsuccessful attempted open repair.…”

Section: Discussionmentioning

confidence: 99%

Salvage repair of rare iatrogenic bilateral ureteral injury after hysterectomy

Han

Khetrapal²,

Consigliere

et al. 2015

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Ureteric injury is a well-documented complication of gynecological surgery, however, bilateral ureteric injuries are rarely encountered and there is no consensus on the management of such complex injuries. We present our successful management of iatrogenic bilateral ureteric injuries in a patient after failed primary endourological surgery and attempted open repair. Our patient is a thirty-five years-old woman who sustained bilateral ureteral injury after open radical hysterectomy to treat a squamous cell carcinoma of her uterus. She subsequently became reliant on bilateral ureteral stents following a failed open surgical repair of her left ureter. Upon evaluation, retrograde pyelogram showed bilateral ureteral strictures with hydronephrosis and ureteroscope could not be passed beyond the tight strictures in the ureters following removal of double-J stents. Open bilateral repair of ureters aims to achieve tension-free bilateral ureteroneocystostomies with a unilateral right psoas hitch. We discussed the adaptations of conventional technique involving tunneling of the left ureter underneath the sigmoid mesentery. She recovered well and was stable on discharge. Upon follow-up in clinic one year later, hydronephrosis resolved completely with conserved renal function. Therefore, we demonstrated and outlined the principles in our successful approach and showed that it is feasible to treat bilateral ureteral injuries following hysterectomy with open repair in spite of unsuccessful primary endourological surgery and attempted open repair.

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Section: Discussionmentioning

confidence: 99%

Salvage repair of rare iatrogenic bilateral ureteral injury after hysterectomy

Han

Khetrapal²,

Consigliere

et al. 2015

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“…The Boari flap is a technique which utilizes a flap of the bladder to repair longer segment distal ureteral strictures. Typical ureteral reimplantation is performed for short defects of 4 to 5 cm, but utilizing the Boari flap can allow for reconstruction of ureteral defects up to a length of 15 cm ( 10 ). The procedure has been described robotically by Stolzenburg.…”

Section: Boari Flapmentioning

confidence: 99%

Robotics and urologic reconstructive surgery

Sun¹,

Granieri²,

Zhao³

2018

Transl. Androl. Urol.

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Minimally invasive surgery has made a profound impact on how urologists approach the challenges in reconstruction of the urinary tract. The advent of laparoscopic approaches to reconstructive urology have demonstrated comparable outcomes to open surgery with improved morbidity. The recent adoption of robotic surgery has seen further advancements such as improved visibility and, freedom of movement, and an easier technical learning curve. With these advantages, more reconstructive urology procedures are being performed robotically. Herein, we review reconstructive urology procedures for which robotics have been applied.

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“…Recently, case series on robotic-assisted ureteral reimplantation including psoas hitch and Boari flap report outstanding functional outcomes of 94-100 % [55][56][57][58][59][60]. One study compared robotic and open ureteral implantation in 20 matched patients and reported EBL and hospital stay were significantly reduced in the robotic group, and although operative time was higher, this variable was not statistically significant [57].…”

Section: Functional Outcomes Ureteral Reconstructionmentioning

confidence: 99%

Functional Outcomes of Bladder Reconstruction Secondary to Trauma and Ureteral Injury

Faris

2015

Curr Bladder Dysfunct Rep

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Injury to the ureter and bladder are relatively rare occurrences and provoke significant diagnostic dilemmas. Etiologies include external trauma, such as automobile accidents or gunshot wounds, and iatrogenic injuries during pelvic surgery or endoscopy. When lower urinary tract injury goes unrecognized, presenting symptoms can be vague and often delay diagnosis. Such delays may result in prolonged hospital stays and deterioration of renal function and have significant impact on a patient's quality of life. Reconstruction of these injuries can be challenging depending on the mechanism and location of injury. Overall functional outcomes of reconstruction for ureteral or bladder injuries is excellent, but there is limited data on post-operative voiding function. One unique injury worth mentioning is mesh erosion into the genitourinary tract where patients may have persistent lower urinary tract symptoms after reconstruction.

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Robot-Assisted Technique for Boari Flap Ureteral Reimplantation: Is Robot Assistance Beneficial?

Cited by 38 publications

References 19 publications

Salvage repair of rare iatrogenic bilateral ureteral injury after hysterectomy

Salvage repair of rare iatrogenic bilateral ureteral injury after hysterectomy

Robotics and urologic reconstructive surgery

Functional Outcomes of Bladder Reconstruction Secondary to Trauma and Ureteral Injury

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