title: Robot-assisted anterior wall extravesical ureteral reimplantation.
abstract: BACKGROUND
  Here we describe our technique for robot-assisted, extravesical, anterior wall ureteral reimplantation for select patients with obstructive megaureter or high grade VUR with paraureteral diverticulum. We performed anterior wall reimplantation, extrapolating our experience with anterior wall appendicovesicostomy [Famakinwa et al., Eur Urol 2013;64(5):831-6]
  
  
  METHODS
  We applied this technique at our institution for a total of 6 patients: 4 pediatric, 2 adult. Amongst our pediatric patients, 3 underwent surgery for obstructive megaureter, and 1 for a paraureteral bladder diverticulum with high grade VUR. Our 2 adult patients opted for surgery in the setting of distal ureteral strictures. To avoid ureteral kinking, we perform detrusorotomy in alignment with the ureter, and take care to avoid ureteral laxity during reimplantation.
  
  
  RESULTS
  Following surgery, each of our 6 patients continues to remain without evidence of obstruction, including ureteral kinking, with follow-up ranging from 3 months to 5 years. No procedural-related complications have been noted to date.
  
  
  CONCLUSIONS
  We have found this approach to be technically straightforward, avoiding intravesical dissection and associated morbidity of bladder spasm, while achieving functional outcomes.
authors.affiliation: University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA. Electronic address: jason.joseph@me.com.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Joseph
authors.affiliation: Center for Pediatric Robotic and Minimal Invasive Surgery, Department of Surgery, Division of Urology, University of Chicago Medicine and Biological Sciences, 5841 S. Maryland Avenue, MC 7122, Chicago, IL 60637, USA. Electronic address: mgundeti@surgery.bsd.uchicago.edu.
authors.forename: Mohan S
authors.initials: MS
authors.lastname: Gundeti
mesh_terms: D000328:Adult; D002648:Child; D004240:Diverticulum / Q000601:surgery*; D006801:Humans; D012092:Replantation / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D001743:Urinary Bladder / Q000002:abnormalities* / Q000601:surgery; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
keywords: Anterior wall reimplant; Extravesical; Robotic; Ureter; Ureteral reimplantation; Ureteroneocystotomy