Robotic Distal Ureterectomy with Boari Flap Reconstruction for Distal Ureteral Urothelial Cancers: A Single Institutional Pilot Experience

Allaparthi, Satya; Rajan, Rajesh; Balaji, K.C.

doi:10.1089/lap.2009.0269

Cited by 34 publications

(20 citation statements)

References 29 publications

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“…Although early reports of the robotic approach have been addressed by others for cases involving malignancy, we have thus far limited our experience to benign indications. 19,20 While we have significant experience with both laparoscopic and robot-assisted urologic procedures, our preferred approach for distal/mid ureteral reimplantation currently favors robotic assistance over pure laparoscopy. We believe the distal ureter dissection and unique angles involved during suturing are aided by robot assistance.…”

Section: Discussionmentioning

confidence: 99%

Robotic Versus Open Distal Ureteral Reconstruction and Reimplantation for Benign Stricture Disease

Kozinn

Canes

Sorcini

et al. 2012

Journal of Endourology

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Section: Discussionmentioning

confidence: 99%

Robotic Versus Open Distal Ureteral Reconstruction and Reimplantation for Benign Stricture Disease

Kozinn

Canes

Sorcini

et al. 2012

Journal of Endourology

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“…[3,[6][7][8][9][10][11][12][13][14][15][16][17] Rassweiler et al [7] observed longer operative time (253 minutes vs. 220 minutes), shorter hospital stay (8 days vs.17 day) with 100% successs rate in the [11] 1 210 3 90 50 mg morphine…”

Section: Discussionmentioning

confidence: 99%

“…Ramalingam et al [8] Allarpathi et al [15] 2 RALBF UT 1 M 2R 245 2 30 6 22 mg morphine 1F Soares et al [16] 2 H 2F 1R US 1L 120 2 140 6 Gozen et al Ramalingam et al [8] performed laparoscopic ureteral reimplantation with Boari flap in 3 patients successfully with median operative time of 320 mins (range 300-320 min). Castillo et al [9] reported 9 cases of laparoscopic reimplantation procedure with Boari flap.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic ureteral reimplantation with Boari flap for the management of long- segment ureteral defect: A case series with review of the literature

Bansal¹,

Sinha²,

Jhanwar³

et al. 2017

Turkish Journal of Urology

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Objective: The incidence of ureteral stricture is showing a rising trend due to increased use of laparoscopic and upper urinary tract endoscopic procedures. Boari flap is the preferred method of repairing long-segment ureteral defects of 8-12 cm. The procedure has undergone change from classical open (transperitoneal and retroperitoneal) method to laparoscopic surgery and recently robotic surgery. Laparoscopic approach is cosmetically appealing, less morbid and with shorter hospital stay. In this case series, we report our experience of performing laparoscopic ureteral reimplantation with Boari flap in 3 patients. Material and methods:This prospective study was conducted between January 2011 December 2014. The patients with a long-segment ureteral defect who had undergone laparoscopic Boari flap reconstruction were included in the study. Outcome of laparoscopic ureteral reimplantation with Boari flap for the manangement of long segment ureteral defect was evaluated. Results:The procedure was performed on 3 patients, and male to female ratio was 1:2. One patient had bilateral and other two patient had left ureteral stricture. The mean length of ureteral stricture was 8.6 cm (range 8.2 -9.2 cm). The mean operative time was 206 min (190 to 220 min). The average estimated blood loss was 100 mL (range 90-110 mL) and mean hospital stay was 6 days (range 5 to 7 days). The mean follow up was 19 months (range 17-22 months). None of the patients experienced any complication related to the procedure in perioperative period. Conclusion:Laparoscopic ureteral reimplantation with Boari flap is safe, feasible and has excellent long term results. However, the procedure is technically challenging, requires extensive experience of intracorporeal suturing.

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“…Schimpf y cols, en el 2008 fueron los primeros en publicar un caso de neoimplante vesicoureteral con técnica de fl ap Boari con asistencia robótica en un caso de estenosis ureteral benigna con resultados muy satisfactorios 19 . En relación a la confección de esta técnica asistida por robot para neoplasias del uréter distal, existen sólo dos casos publicados por Allaparthi y cols, en 2010, con buenos resultados quirúrgicos, aún cuando con se guimiento aún corto 7 . En esta comunicación aportamos un caso adicional a la literatura de ureterectomía distal por tumor de urotelio con neoimplante vesicoureteral según la técnica de Flap Boari asistida por robot da Vinci.…”

Section: Discussionunclassified

“…En el año 2005 presentamos nuestra experiencia inicial con esta técnica laparoscópica en la resolución de lesiones ureterales benignas 4 , y en el año 2008 comunicamos su aplicación en 2 casos de lesiones tumorales de uréter distal 5 . Existen sólo 2 reportes de su uso por vía laparoscópica en cirugía oncológica 5,6 ; sin embargo, a la actualidad han sido comunicado sólo 2 casos de cirugía robótica 7 . Presentamos un caso de carcinoma urotelial del uréter distal al que se le realizó ureterectomía distal con neoimplante vesicoureteral según la técnica de Boari asistida por robot.…”

Section: Introductionunclassified

Ureterectomía radical distal por cáncer urotelial y reconstrucción ureteral asistida por robot

López-Fontana²,

M³

et al. 2011

Rev Chil Cir

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Radical distal ureterectomy secondary to an urotelial cancer and ureteral reconstruction robot-assisted. Case report Objective: To report a case of distal ureterectomy with robotic-assisted laparoscopic reimplantation using a Boari fl ap technique. Material and Methods: We report a 55 year old man with a diagnosis of distal ureteral urothelial carcinoma without multifocality. Results: A radical distal ureterectomy and robotic-assisted laparoscopic vesicoureteral reimplantation using a Boari fl ap technique was performed with the da Vinci S-HD surgical system. The operative time was 210 minutes, the estimated blood loss was 200 mL. The hospital stay was 48 hours, without perioperative complications. The histopathological study showed a high grade nonmuscle invasive urothelial carcinoma of the distal ureter (pT1NxMx) with negative margins. Conclusions: The distal radical ureterectomy with Boari replacement is feasible and more precise with robotic assistance. Its oncological role must be demostrated with a larger number of cases.Key words: Urotelial carcinoma, ureteral tumor, ureterectomy, Boari fl ap, ureteroneocystostomy, robotic surgery. ResumenObjetivo: Comunicar un caso de tumor ureteral distal tratado con ureterectomía radical y neoimplante vesicoureteral con técnica de Flap Boari asistida por robot. Material y Métodos: Paciente hombre de 55 años, con diagnóstico de carcinoma urotelial de uréter distal sin compromiso multifocal. Resultados: Se realizó ureterectomía distal radical y neoimplante vesicoureteral con Flap Boari asistido por Robot da Vinci S-HD. El tiempo operatorio fue de 210 minutos, con un sangrado estimado de 200 ml. La estadía hospitalaria fue de 48 horas, sin complicaciones perioperatorias. El estudio histológico mostró un carcinoma urotelial de alto grado con infi ltración de la lámina propia (pT1NxMx) y márgenes quirúrgicos negativos. Conclusiones: La ureterectomía radical distal con reconstrucción tipo Boari es técnicamente factible y más precisa con la asistencia robótica. Su rol oncológico requiere de validación con mayor número de casos.Palabras clave: Cáncer de urotelio, tumor ureteral, ureterectomía, fl ap de Boari, ureteroneocistostomía, cirugía robótica.

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Robotic Distal Ureterectomy with Boari Flap Reconstruction for Distal Ureteral Urothelial Cancers: A Single Institutional Pilot Experience

Abstract: RDUBF reconstruction is technically feasible with using DSRS in select patients with distal ureteral cancer without disease recurrence in the short term. A larger cohort, with long-term follow-up, is necessary to validate our results.

Cited by 34 publications

References 29 publications

Robotic Versus Open Distal Ureteral Reconstruction and Reimplantation for Benign Stricture Disease

Robotic Versus Open Distal Ureteral Reconstruction and Reimplantation for Benign Stricture Disease

Laparoscopic ureteral reimplantation with Boari flap for the management of long- segment ureteral defect: A case series with review of the literature

Ureterectomía radical distal por cáncer urotelial y reconstrucción ureteral asistida por robot

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