Korean J Urol.  2009 Sep;50(9):921-924.

Robot-Assisted Laparoscopic Distal Ureterectomy and Ureteral Reimplantation

• Kang SG
• Choi H
• Ko YH
• Tae BS
• Cho S
• Ahn HJ
• Chae JY
• Kang SH
• Cheon J

Abstract

We report here on our technique and outcomes of the first case of robot-assisted laparoscopic distal ureterectomy with a bladder cuff excision and ureteroneocystostomy. A 74-year-old male patient who had a distal ureter tumor underwent robot-assisted transperitoneal distal ureterectomy. After distal ureterectomy with bladder cuff excision was performed, direct ureteroneocystostomy was performed. The whole procedure was successfully performed by using the robot without conversion to open surgery. The total operative time was 207 minutes, and the estimated blood loss was 30 ml. The final pathological examination showed stage T2 invasive transitional cell carcinoma of the distal ureter. The patient's postoperative recovery was uneventful and the bladder cuff was free of tumor. Robot-assisted laparoscopic distal ureterectomy with ureteroneocystostomy is safe and feasible and offers patients the advantages of minimally invasive surgery.

Keyword

Robotics; Carcinoma; Transitional cell; Ureter

MeSH Terms

Aged
Carcinoma, Transitional Cell
Conversion to Open Surgery
Humans
Male
Operative Time
Replantation
Robotics
Ureter
Urinary Bladder

Figure

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  Fig. 1 (A) CT scan showing enhancing wall thickening (arrow) in the distal ureter. (B) Post-CT KUB showing left hydronephroureterosis and distal ureteral obstruction (arrow).

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  Fig. 2 Port placement of distal ureterectomy with ureteral reimplantation: 10 mm robotic camera port; two 8 mm robotic arm ports; 5 mm assistant port.

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  Fig. 3 Resection of the distal ureter and bladder cuff. Bladder opening (arrow).

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  Fig. 4 The external tunnel method of implantation was performed.

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