Robot-Assisted Ureterectomy and Ureteral Reconstruction for Urothelial Carcinoma

Abstract

Robot-assisted ureterectomy and ureteral reconstruction is safe and feasible, and offers patients the advantages of minimally invasive surgery. Future studies with additional patients and longer follow-up will determine the oncologic effectiveness of this procedure.

Oncologic Outcomes for Complete Robot-Assisted Laparoscopic Management of Upper-Tract Transitional Cell Carcinoma

“…Some authors have recently described robot-assisted reconstructive surgery of the distal ureter for benign stricture disease; however, only one case series evaluated robot-assisted distal ureterectomy with reconstruction for distal ureteral TCC. [16][17][18][19][20][21] Analysis of our experience shows similar oncologic outcomes compared with open or laparoscopic management of upper-tract TCC. 3,4,[22][23][24] For RAL nephroureterectomy, at a mean follow-up of 15.2 months, 4 of the 11 patients experienced disease recurrence.…”

“…Although some have described robot-assisted reconstructive surgery of the distal ureter for benign stricture disease, only one case series evaluated robot-assisted distal ureterectomy with reconstruction for distal ureteral TCC. [16][17][18][19][20][21] In our series, management of the kidney as well as distal ureter with bladder cuff for nephroureterectomy was performed using only robot-assisted dissection. To the best of our knowledge, we are the first to report on the complete robotic approach for RAL nephroureterectomy.…”

Laparoscopic ureteral reimplantation using the dome advancement technique: A case series and review of the literature

“…On follow up, stricture recurrence was found in four patients among the reported cases. Three were treated by endoscopic means, but two of them required prolonged ureteral stenting, despite the salvage treatment 27,28,33 . One patient required ileal interposition to tackle the recurrent stricture disease 27 .…”

“…Three were treated by endoscopic means, but two of them required prolonged ureteral stenting, despite the salvage treatment. 27,28,33 One patient required ileal interposition to tackle the recurrent stricture disease. 27 Despite the relatively short follow-up duration of most of the reported series, the overall success rates, in terms of absence of recurrence of stricture or symptoms, was high (96.6 per cent or 144/149).…”

“…Intraoperative Inadvertent ureterotomy made in area of normal ureter 27 2 Injury to external iliac vein 23 1 Thermal injury to small intestines 33 1 Postoperative Clostridium difficile colitis 6, 27 1 Partial small bowel obstruction 27 1 Urine leakage 15,19,27 5 Pulmonary embolism 15 1 Ileus 32 2 Aspiration pneumonia 28 1 Total 15…”