Robot-assisted ureteroureterostomy in the adult: initial clinical series.
OBJECTIVE
To report what we believe is the first series of robot-assisted ureteroureterostomy (RAUU) in adults with greater than 24-month follow-up because ureteral stricture disease can be difficult to manage.


METHODS
During 2004-2006, a total of 3 patients were found to have complex ureteral pathology: 2 with refractory symptomatic ureteral strictures and 1 with a complete ureteral transection. After thorough discussion of all available treatment options, these patients agreed to undergo RAUU.


RESULTS
All patients had successful primary reanastomosis of the ureter robotically. Average operating room time was 136.6 minutes. Mean hospital stay was 3 days. All patients had ureteral stents placed during the operation. All patients at last follow-up were noted to be pain free with stable T(1/2) on nuclear renal scan.


CONCLUSIONS
RAUU is a potential treatment option for ureteral strictures in carefully selected patients. These cases may include failed endopyelotomy, refractory ureteral stricture, or cases of ureteral transection in which a ureteral reimplantation may be difficult. The robotic platform provides excellent reconstructive capabilities that may be difficult to obtain for surgeons who are not performing laparoscopic cases in high volume.
Lee
David I
DI
Division of Urology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. david.lee@uphs.upenn.edu
Schwab
C William
CW
Harris
Andrew
A
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012371:Robotics; D014517:Ureteral Obstruction / Q000601:surgery*; D014519:Ureterostomy / Q000379:methods*; D055815:Young Adult