title: Robot-assisted laparoscopic ureteral reimplantation with excisional tailoring for refluxing megaureter.
abstract: OBJECTIVE
  To demonstrate a novel technique for robot-assisted laparoscopic excisional tailoring and reimplantation of a refluxing megaureter.
  
  
  METHODS
  A 9-year-old boy with dysfunctional elimination was found to have a refluxing megaureter and diminished ipsilateral renal function. Robotic ureteral reimplantation with excisional tailoring was performed using a three-port approach. Stay sutures were placed in the anterior aspect of the distal ureter and sequentially lifted to allow freehand excision of redundant ureter. The ureterovesical junction was left intact, and the ureter was repaired over a 6 Fr double-J stent. Detrusorotomy to create flaps for ureteral tunneling was performed with a carbon dioxide (CO2) laser.
  
  
  RESULTS
  The patient's vesicoureteral reflux was successfully corrected, and he is now asymptomatic.
  
  
  CONCLUSIONS
  Specific technical modifications can facilitate robotic megaureter repair with intracorporeal excisional tailoring. The CO2 laser is advantageous for detrusorotomy.
authors.affiliation: Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 24, Chicago, IL 60611, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Faasse
authors.affiliation: Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 24, Chicago, IL 60611, USA.
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Lindgren
authors.affiliation: Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 24, Chicago, IL 60611, USA. Electronic address: egong@luriechildrens.org.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Gong
mesh_terms: D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012092:Replantation / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*; D014718:Vesico-Ureteral Reflux / Q000209:etiology / Q000601:surgery*
keywords: Laparoscopy; Megaureter; Robotics; Ureteral reimplantation; Vesicoureteral reflux