Single-Port Endorobotic Rectal Mucosa Harvest For Urethral Reconstruction

Özgür, İlker; Justiniano, Carla F.; Wood, Hadley M.; Görgün, Emre

doi:10.1097/dcr.0000000000002577

Cited by 2 publications

(2 citation statements)

References 6 publications

(5 reference statements)

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“…Harvest can be performed both via a multi-port robot with a transanal access port or a single port robot ( 3 , 57 , 58 ). The robot is docked transanally with the patient in the dorsal lithotomy position.…”

Section: Resultsmentioning

confidence: 99%

“…Rectal mucosa has been used to close rectourethral and rectovesical fistulas by numerous surgeons, with a high degree of success ( 39 , 59 , 60 ). Rectal mucosa can also be harvested in a similar manner to oral mucosa and used as a graft for replacement of other structures for substitution urethroplasties or complex vaginal reconstruction ( 3 , 57 , 58 ). One advantage of rectal mucosa over buccal mucosa is that the graft that can be harvested can be quite large, allowing for management of very long strictures ( 3 , 57 ).…”

Section: Resultsmentioning

confidence: 99%

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Narrative review of flaps and grafts in robotic reconstructive urologic surgery

Doersch,

Hines,

Ajay

2024

Ann Laparosc Endosc Surg

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Background and Objective: Flaps and grafts are used for filling dead space, ureteral substitution, and as mesh alternatives. The surgical robot is invaluable in urologic reconstructive surgery due to the ability of the robot to reach the deep pelvis, its minimally invasive access, the ability to use indocyanine green to identify structures and assess tissue perfusion and viability, and ergonomics for the surgeon. Robotic reconstruction can involve tissue transfer in the form of flaps and grafts to provide form and function to organs that have been damaged by iatrogenic injuries, trauma, infections, cancer, radiation injury, or congenital abnormalities. Common flaps and grafts can be readily adapted to the robotic approach. In this literature review, we examine the robotic use of flaps and grafts in reconstructive urology. Methods: A thorough literature review was conducted via a PubMed search for predefined terms. Key Content and Findings: Flaps and grafts in reconstructive urology are used for interposition, ureteral substitution, and as mesh alternatives. Omental flaps are used for tissue interposition, or to provide structure and nutrients, and are easily employed with the robot. Various robotic applications of peritoneal flaps have been described. Vascular rectus abdominis musculocutaneous flaps are well-vascularized flaps that occupy dead space and provide structural support, which can be harvested readily with the robot. Sigmoid epiploica are an excellent flap for pelvic reconstruction. Gracilis flaps and fascia lata grafts are well-tolerated and provide space occupying tissue. Boari flaps aid in robotic ureteral reconstruction, especially in the setting of long defects. Oral mucosa is excellent for ureteral or bladder neck reconstruction. Rectal mucosa is well-tolerated and easy to harvest robotically for a variety of urinary tract reconstructive applications. The appendix or ileum can be interposed for repair of damaged ureters. Conclusions: Various flaps and grafts have been adapted for robotic reconstructive urology. As the field develops, refinement of techniques and innovation in flaps and employment of the robot will propel this field forward. More studies, especially comparative studies, are needed to elucidate the flaps and grafts that are most likely to be successful with the least morbidity for each use case.

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Section: Resultsmentioning

confidence: 99%