Ureteral Reimplantation via Robotic Nontransecting Side-to-Side Anastomosis for Distal Ureteral Stricture

Jeremy Slawin, Neel H. Patel, Ziho Lee, Geolani W. Dy, Daniel Kim, Aeen Asghar, Helaine Koster, Michael Metro, Lee Zhao, Michael Stifelman, Daniel D. Eun

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To describe a novel technique of ureteral reimplantation through robotic nontransecting side-to-side anastomosis. Although the standard approach to ureteroneocystostomy has a high rate of success, it involves transection of the ureter that may impair vascularity and contribute to recurrent strictures. Our method seeks to maximally preserve distal ureteral blood flow that may reduce this risk. Materials and Methods: We retrospectively reviewed a multi-institutional ureteral reconstruction database to identify patients who underwent this operation between 2014 and 2018, analyzing perioperative and postoperative outcomes. Results: Our technique was utilized in 16 patients across three U.S. academic institutions. Median operative time and estimated blood loss were 178 minutes (interquartile range [IQR] 150-204) and 50 mL (IQR 38-100), respectively. The median length of stay was 1 day (IQR 1-2). No intraoperative complications or postoperative complications with Clavien score ≥3 were reported. Postoperatively, 15 of 16 (93.8%) patients reported clinical improvement in flank pain, and all patients who underwent follow-up imaging had radiographic improvement with decrease in hydronephrosis at a median follow-up of 12.5 months. Conclusions: Ureteral reimplantation through a robotic nontransecting side-to-side anastomosis is a feasible and effective operation for distal ureteral stricture that may have advantages over the standard of care transecting ureteroneocystostomy.

Original languageEnglish (US)
Pages (from-to)836-839
Number of pages4
JournalJournal of Endourology
Volume34
Issue number8
DOIs
StatePublished - Aug 1 2020
Externally publishedYes

Keywords

  • nontransecting
  • reconstructive surgery
  • robotic surgery
  • transection free
  • ureteral reimplant
  • ureteral stricture
  • ureteroneocystostomy

ASJC Scopus subject areas

  • Urology

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