IPEG 2020 TOP ABSTRACT: Robotic Surgery for Iatrogenic Ureterovesical Stenosis

Patient was a 3-year-old boy followed for antenatal hydronephrosis who had undergone 2 subureteric injections at another center for vesicoureteral reflux

Severe right ureterovesical stenosis was detected on MR urography in a child with recurrent urinary tract infections

Right kidney function was 11% on DMSA scan preoperatively

In robotic surgery, the camera trocar was placed approximately 3 cm above the umbilicus in the midline, unlike conventional laparoscopic surgery

Right and left 8mm robotic working ports were placed where the umbilicus level and the anterior axillary line cross

A 10mm assistant trocar was placed between the camera trocar and the left robotic trocar

Severe right ureteral dilatation was observed intraoperatively

The ureterovesical junction was found to be extremely fibrotic and stenotic

Previously performed injection materials were cleaned from the area

After transection of the ureterovesical junction, no leakage was observed from the filled bladder

The serotomy line was marked to be 4 cm in length for ureteral tapering

Ureteral tapering was performed rapidly and comfortably due to unique advantages of robotic arms

Ureteral reimplantation was performed in continuous fashion with 5-0 Vicryl suture

A double-J catheter was inserted when the posterior ureterovesical anastomosis was completed

Leak control was performed with saline and no leakage was observed

The patient was discharged on postoperative day 8

During the follow-up period, no urinary infection was observed

Right renal function improved to 16% on DMSA at 2-year follow-up