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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

Post–operative IVP showing no contrast extravasation and prompt emptying of contrast from the ileal ureter segment.
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Figure 0003: Post–operative IVP showing no contrast extravasation and prompt emptying of contrast from the ileal ureter segment.

Mentions: The median age of our 5 patients is 61 (range 42–73). The etiology of the ureteric strictures in our patients is retroperitoneal fibrosis, radiation stricture, ureteric avulsion and idiopathic fibrosis in 2 patients (Table 1). All of our patients had a normal preoperative glomerular filtration rate (GFR). The median operative time was 250 minutes (range 150–320) and median blood loss was 100 ml (range 50–200). All of our patients have a double J stent and drain inserted intra–operatively. The median hospital stay was 8 days (range 6–10). One patient developed post–operative fever with no obvious source and responded to an antibiotic treatment. The patient who underwent robotic ileal ureter was noted to have proximal migration of double J stent during routine stent removal at 6 weeks post–operatively. The stent was removed under general anesthesia and there were no further complications. All patients underwent double J stent removal at 6 weeks post surgery. At median follow up of 22 months (range 4–38), there were no recurrence of stricture on post–operative IVU or any other complications (Figure 3).


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)

Post–operative IVP showing no contrast extravasation and prompt emptying of contrast from the ileal ureter segment.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0003: Post–operative IVP showing no contrast extravasation and prompt emptying of contrast from the ileal ureter segment.
Mentions: The median age of our 5 patients is 61 (range 42–73). The etiology of the ureteric strictures in our patients is retroperitoneal fibrosis, radiation stricture, ureteric avulsion and idiopathic fibrosis in 2 patients (Table 1). All of our patients had a normal preoperative glomerular filtration rate (GFR). The median operative time was 250 minutes (range 150–320) and median blood loss was 100 ml (range 50–200). All of our patients have a double J stent and drain inserted intra–operatively. The median hospital stay was 8 days (range 6–10). One patient developed post–operative fever with no obvious source and responded to an antibiotic treatment. The patient who underwent robotic ileal ureter was noted to have proximal migration of double J stent during routine stent removal at 6 weeks post–operatively. The stent was removed under general anesthesia and there were no further complications. All patients underwent double J stent removal at 6 weeks post surgery. At median follow up of 22 months (range 4–38), there were no recurrence of stricture on post–operative IVU or any other complications (Figure 3).

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