title: Robotic-assisted repair of iatrogenic ureteral ligation following robotic-assisted hysterectomy.
abstract: OBJECTIVE
  Ureteral injuries, while rare, do occur during gynecologic procedures. The expansion of laparoscopic and robotic pelvic surgical procedures increases the risk of ureteral injury from these procedures and suggests a role for minimally invasive approaches to the delayed repair of ureteral injuries. We present, to our knowledge, the first case of delayed robotic-assisted ureteral deligation and ureterolysis following iatrogenic ureteral injury occurring during a robotic abdominal hysterectomy.
  
  
  METHODS
  We present a case report and review of the literature.
  
  
  RESULTS
  A 57-year-old female underwent a seemingly uncomplicated robotic-assisted laparoscopic total abdominal hysterectomy and bilateral oophorectomy for symptomatic fibroids. On postoperative day 8, she presented with persistent right flank pain. Imaging studies revealed high-grade ureteral obstruction consistent with suture ligation of the right ureter. She underwent successful robotic-assisted ureteral deligation and ureterolysis. Her postoperative course was unremarkable, and she was discharged home on postoperative day 1 from the deligation.
  
  
  CONCLUSIONS
  Robotic-assisted management of complications from urologic or gynecologic surgery is technically feasible. This can potentially preserve the advantages to the patient that are being seen from the initial less-invasive surgery.
authors.affiliation: Department of Urology, University of California Irvine Medical Center, Orange, California, USA.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Kalisvaart
authors.forename: David S
authors.initials: DS
authors.lastname: Finley
authors.forename: David K
authors.initials: DK
authors.lastname: Ornstein
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects; D008026:Ligation; D008875:Middle Aged; D012371:Robotics; D014513:Ureter / Q000293:injuries* / Q000601:surgery*