title: Robot-assisted repair of ureteroileal anastomosis strictures: initial cases and literature review.
abstract: OBJECTIVE
  Ureteroileal anastomosis strictures are well-known complications of ileal conduit urinary diversion that occur in 4% to 8% of patients. Open surgical repair is the standard definitive treatment with minimally invasive, endoscopic approaches developed to prevent the need for major surgery when possible. Robot-assisted surgery has been applied to most primary urologic procedures, but the role of this surgery in the management of complications is undefined. We report our experience with two cases of robotic repair of ureteroileal anastomotic strictures after robot-assisted cystectomy, the first such cases to our knowledge, and review the literature regarding management of these strictures.
  
  
  METHODS
  Two patients underwent robot-assisted ureteroileal anastomosis revision for left-sided strictures of 1 and 6 cm in length after failed endoscopic management. Three ports were used in the first and four in the second procedure. The diseased segment was identified, and the healthy end of the ureter anastomosed to a new site on the conduit with a temporary stent. In the second case, the conduit was mobilized and brought to the end of the ureter for a tension-free anastomosis because of the length of the stricture.
  
  
  RESULTS
  Both patients were discharged on the first postoperative day without complications and are without recurrence after nearly 2 and 3 years since the robotic procedure.
  
  
  CONCLUSIONS
  Minimally invasive definitive revision of ureteroileal anastomotic strictures is feasible with a robotic surgical approach. The advantages of robotic instrumentation allowed successful repair in two patients after previous robot-assisted cystectomy and avoided major open surgery.
authors.affiliation: Robotic Urologic Surgery, Department of Urology, The Ohio State University Medical Center & James Cancer Hospital, 410 W. 10th Avenue, Columbus, OH 43210, USA.
authors.forename: Pankaj P
authors.initials: PP
authors.lastname: Dangle
authors.forename: Ronney
authors.initials: R
authors.lastname: Abaza
mesh_terms: D000714:Anastomosis, Surgical; D003251:Constriction, Pathologic; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014945:Wound Healing