Alvin C Goh1, Richard E Link. 1. Scott Department of Urology, Baylor College of Medicine, 6620 Main Street, Suite 1325, Houston, TX 77030, USA. goh@bcm.edu
Abstract
OBJECTIVE: To discuss the clinical implications of primary obstructed congenital megaureter in the adult and illustrate a minimally-invasive approach for surgical intervention. METHODS: We present the case of a 51-year-old man with a longstanding history of symptomatic congenital megaureter, illustrating an approach for robot-assisted tapered ureteral reimplantation. Ureteral dissection, tapering, and nonrefluxing ureteroneocystostomy were all completed using a robot-assisted laparoscopic technique. RESULTS: The total operative time was 262 minutes, with an estimated blood loss of 150 mL. The patient's hospital course was uneventful, with discharge on postoperative day 4 without a Foley catheter or drain. A diuretic renal scan was performed at 5 months that showed good preservation of renal function with rapid clearance of tracer on the reconstructed side. The patient was pain free at his last follow-up visit without any symptoms. CONCLUSIONS: We have demonstrated a technique for robot-assisted tapered nonrefluxing ureteral reimplantation for congenital megaureter. Robotic assistance provided a safe and effective approach for complex ureteral reconstruction while minimizing morbidity.
OBJECTIVE: To discuss the clinical implications of primary obstructed congenital megaureter in the adult and illustrate a minimally-invasive approach for surgical intervention. METHODS: We present the case of a 51-year-old man with a longstanding history of symptomatic congenital megaureter, illustrating an approach for robot-assisted tapered ureteral reimplantation. Ureteral dissection, tapering, and nonrefluxing ureteroneocystostomy were all completed using a robot-assisted laparoscopic technique. RESULTS: The total operative time was 262 minutes, with an estimated blood loss of 150 mL. The patient's hospital course was uneventful, with discharge on postoperative day 4 without a Foley catheter or drain. A diuretic renal scan was performed at 5 months that showed good preservation of renal function with rapid clearance of tracer on the reconstructed side. The patient was pain free at his last follow-up visit without any symptoms. CONCLUSIONS: We have demonstrated a technique for robot-assisted tapered nonrefluxing ureteral reimplantation for congenital megaureter. Robotic assistance provided a safe and effective approach for complex ureteral reconstruction while minimizing morbidity.
Authors: Ciro Esposito; Lorenzo Masieri; Henri Steyaert; Maria Escolino; Raffaele Cerchione; Angela La Manna; Chiara Cini; Thomas S Lendvay Journal: World J Urol Date: 2017-12-16 Impact factor: 4.226