Wake Forest University Department of Urology, Winston-Salem, North Carolina, USA.
Curr Opin Urol. 2012 Jan;22(1):70-7. doi: 10.1097/MOU.0b013e32834d4c8c.
Surgeon-controlled, robotic-assisted, ureteral reconstructive and ablative surgery is being performed routinely for both benign and malignant pathology at centers possessing this technology in their armamentarium. The aim of this review is to detail the options for surgeon-controlled robotic management of ureteral pathology and evaluate the developments in the last 2 years.
Surgeon-controlled robotic management of ureteric pathology involving all parts of the ureter with varying cause has been reported. Proximally, ureteral strictures and symptomatic retrocaval ureters have been repaired with long-term follow-up demonstrating resolution of obstruction. Ureterolysis and other mid-ureteral pathology have been treated with durable function results. Transitional cell carcinoma of the renal pelvis or distal ureter has been extirpated with successful oncologic outcomes. Reimplantation of refluxing ureters in children has been demonstrated to provide similar results of open surgery.
Surgeon-controlled, robotic-assisted ureteral surgery is well tolerated, feasible, and effective for ablative and reconstructive indications with minimal complications. Knowledge of anatomy, pathology, experience of surgical team, and appropriate preoperative patient selection augmented with proper port placement to provide excellent exposure is critical to provide optimal outcomes.
在拥有该技术的中心，外科医生控制的机器人辅助输尿管重建和消融手术正在常规用于治疗良性和恶性病变。本文的目的是详细介绍外科医生控制的机器人管理输尿管病变的各种选择，并评估过去 2 年的进展。
已经报道了外科医生控制的机器人处理涉及输尿管各个部位的输尿管病变，病因各不相同。在近端，输尿管狭窄和症状性逆行性输尿管已通过长期随访修复，显示梗阻得到解决。输尿管松解和其他中段输尿管病变的治疗效果持久。肾盂或远端输尿管的移行细胞癌已通过成功的肿瘤学结果切除。儿童反流性输尿管再植入术已被证明与开放手术具有相似的效果。
外科医生控制的机器人辅助输尿管手术具有良好的耐受性、可行性和有效性，适用于消融和重建适应证，并发症少。了解解剖、病理、手术团队的经验以及适当的术前患者选择，加上适当的端口放置以提供良好的暴露，对于提供最佳结果至关重要。
