Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Urology. 2020 May;139:118-121. doi: 10.1016/j.urology.2020.01.020. Epub 2020 Jan 28.
To highlight the feasibility and technical details of performing simultaneous ipsilateral pyeloplasty and ureteric re-implantation for simultaneous proximal and distal obstruction of the ureter.
Two patients with preoperative diagnosis of proximal and distal ureteric obstruction underwent robot-assisted simultaneous pyeloplasty and ureteric re-implantation. The patients were placed in right lateral oblique position and pyeloplasty was performed in standard manner. In both cases, Double J stent could not be negotiated beyond the vesicoureteric junction into the bladder. The robot was dedocked and recentred around different ports to successfully perform uretero-neocystostomy over a 4.8 F double J stent.
The mean operative times were 154 minutes with operative blood loss of approximately 50 ml. The postoperative convalescence was good in both cases and Double J stents were removed after 6 weeks. Follow-up diuretic renograms demonstrated stable renal function with unobstructed drainage.
Simultaneous repair of ipsilateral pelviureteric and vesicoureteric junction obstruction is safe and feasible contrary to traditional teachings. To the best of our knowledge this is the first description of robotic simultaneous pyeloplasty and ureteric reimplantation.
强调同时治疗输尿管近段和远段梗阻的同侧肾盂成形术和输尿管再植入术的可行性和技术细节。
对术前诊断为输尿管近段和远段梗阻的 2 名患者进行机器人辅助同期肾盂成形术和输尿管再植入术。患者取右侧斜卧位，按标准方法行肾盂成形术。在这两种情况下，双 J 支架都不能通过膀胱输尿管连接部进入膀胱。机器人脱机并重新定位到不同的端口，成功地在 4.8 F 双 J 支架上进行了输尿管 - 新膀胱吻合术。
平均手术时间为 154 分钟，术中出血量约 50 毫升。术后恢复良好，均在 6 周后取出双 J 支架。随访利尿剂肾图显示肾功能稳定，引流通畅。
与传统观点相反，同侧肾盂输尿管和膀胱输尿管连接部梗阻的同期修复是安全可行的。据我们所知，这是首次描述机器人同期肾盂成形术和输尿管再植入术。
