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Intracorporeal ileal ureter replacement using laparoscopy and robotics.

Sim A, Todenhöfer T, Mischinger J, Halalsheh O, Boettge J, Rausch S, Bier S, Aufderklamm S, Stenzl A, Gakis G, Schwentner C - Cent European J Urol (2014)

Bottom Line: Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery.We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter.Numbers are still small but its application is likely to grow further.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Eberhard-Karls University, Tuebingen, Germany.

ABSTRACT

Introduction: Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery. We report our experience using minimally invasive techniques for total intracorporeal ureteral replacement.

Material and methods: A chart review revealed five patients who underwent intracorporeal ileal ureter using minimally invasive techniques in the preceding 5 years. 4 patients underwent conventional laparoscopic surgery and 1 patient underwent robotic-assisted surgery. Patient's characteristics, perioperative data and functional outcomes as well as a detailed description of surgical technique are reported. In all 5 of these patients, the ileal ureter was performed completely intracorporeally.

Results: The median age of our patients is 61 (range 42-73). The median operative time was 250 minutes (range 150-320) and median blood loss was 100 ml (range 50-200). The median hospital stay was 8 days (range 6-10) and there were no major perioperative complications reported. At median follow up of 22 months (range 4-38), there were no recurrences of strictures or any other complications.

Conclusions: We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter. Numbers are still small but its application is likely to grow further.

No MeSH data available.


Related in: MedlinePlus

A. Ureter identification and removal of Double J stent; B. Renal pelvis mobilization and suspension; C. Bowel transection using Endo_GIA stapler; D. Transected bowel temporarily fixed to renal pelvis; E. End–to–end anastomosis after distal transection; F – Pyeloileal anasotomosis; G – Ileovesical anastomosis; H – completed isoperistaltic ileal ureter.
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Figure 0001: A. Ureter identification and removal of Double J stent; B. Renal pelvis mobilization and suspension; C. Bowel transection using Endo_GIA stapler; D. Transected bowel temporarily fixed to renal pelvis; E. End–to–end anastomosis after distal transection; F – Pyeloileal anasotomosis; G – Ileovesical anastomosis; H – completed isoperistaltic ileal ureter.

Mentions: A detailed description of the surgical technique of laparoscopic and robotic ileal ureter will be included (Figure 1). Our previous publication with the accompanied video has also demonstrated the key steps involved in laparoscopic ileal ureter [8].


Intracorporeal ileal ureter replacement using laparoscopy and robotics.

Sim A, Todenhöfer T, Mischinger J, Halalsheh O, Boettge J, Rausch S, Bier S, Aufderklamm S, Stenzl A, Gakis G, Schwentner C - Cent European J Urol (2014)

A. Ureter identification and removal of Double J stent; B. Renal pelvis mobilization and suspension; C. Bowel transection using Endo_GIA stapler; D. Transected bowel temporarily fixed to renal pelvis; E. End–to–end anastomosis after distal transection; F – Pyeloileal anasotomosis; G – Ileovesical anastomosis; H – completed isoperistaltic ileal ureter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4310887&req=5

Figure 0001: A. Ureter identification and removal of Double J stent; B. Renal pelvis mobilization and suspension; C. Bowel transection using Endo_GIA stapler; D. Transected bowel temporarily fixed to renal pelvis; E. End–to–end anastomosis after distal transection; F – Pyeloileal anasotomosis; G – Ileovesical anastomosis; H – completed isoperistaltic ileal ureter.
Mentions: A detailed description of the surgical technique of laparoscopic and robotic ileal ureter will be included (Figure 1). Our previous publication with the accompanied video has also demonstrated the key steps involved in laparoscopic ileal ureter [8].

Bottom Line: Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery.We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter.Numbers are still small but its application is likely to grow further.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Eberhard-Karls University, Tuebingen, Germany.

ABSTRACT

Introduction: Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery. We report our experience using minimally invasive techniques for total intracorporeal ureteral replacement.

Material and methods: A chart review revealed five patients who underwent intracorporeal ileal ureter using minimally invasive techniques in the preceding 5 years. 4 patients underwent conventional laparoscopic surgery and 1 patient underwent robotic-assisted surgery. Patient's characteristics, perioperative data and functional outcomes as well as a detailed description of surgical technique are reported. In all 5 of these patients, the ileal ureter was performed completely intracorporeally.

Results: The median age of our patients is 61 (range 42-73). The median operative time was 250 minutes (range 150-320) and median blood loss was 100 ml (range 50-200). The median hospital stay was 8 days (range 6-10) and there were no major perioperative complications reported. At median follow up of 22 months (range 4-38), there were no recurrences of strictures or any other complications.

Conclusions: We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter. Numbers are still small but its application is likely to grow further.

No MeSH data available.


Related in: MedlinePlus