title: Intentional Omission of Ureteral Stents During Robotic-assisted Intracorporeal Ureteroenteric Anastomosis: Is It Safe and Feasible?
abstract: To describe the surgical technique we used to perform a stentless intracorporeal ureteroenteric anastomosis and to determine the outcomes in this initial series.
  
  
  
  We performed a retrospective review of a prospective database of all patients undergoing robotic-assisted intracorporeal urinary diversion with stentless ureteroenteric anastomosis between March 2014 and July 2016. Diversions were performed at the time of either robotic-assisted laparoscopic cystectomy for bladder cancer or urinary diversion for other indications.
  
  
  
  A total of 10 patients underwent implantation of 20 ureters into the intestine via a robotic-assisted approach with intentional omission of stents. Median body mass index was 29.57 (first quartile 23.68, third quartile 34.69). Median American Society of Anesthesiologists score was 3 (range 2-3). Seven patients had intracorporeal ileal conduit reconstruction and 3 patients had an intracorporeal neobladder creation. There were no patients who developed a stricture of the ureter nor did any patient develop a leak at the ureteroenteric anastomosis. All patients had normal serum creatinine at least 4 weeks after surgery, and all patients had follow-up computed tomography of the kidneys, which were normal. The median follow-up was 8 months (first quartile = 3 months, third quartile = 17 months).
  
  
  
  Robotic intracorporeal urinary diversion with intentional omission of ureteral stents is a safe and feasible option when establishing continuity of the genitourinary and gastrointestinal tracts.
authors.affiliation: Department of Urology, Rush University Medical Center, Chicago, IL. Electronic address: tanweiphin@yahoo.com.
authors.forename: Wei Phin
authors.initials: WP
authors.lastname: Tan
authors.affiliation: Department of Urology, Rush University Medical Center, Chicago, IL.
authors.forename: Patrick
authors.initials: P
authors.lastname: Whelan
authors.affiliation: Department of Urology, Rush University Medical Center, Chicago, IL.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Deane
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D015607:Stents; D014513:Ureter / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*