Chiruvella Mallikarjuna, Syed Ghouse Mohammed, Darga Shanti, Kondakindi Purnachandra Reddy, Enganti Bhavatej, Adapala Rajesh Kumar Reddy
Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, India.
Turk J Urol. 2022 Sep;48(5):385-388. doi: 10.5152/tud.2022.22146.
Ureteric reimplantation is the treatment of choice for pelvic lipomatosis with ureteric obstruction. Pelvic adherent fat poses a technical challenge during this surgery.
We describe the robotic approach to facilitate the precise dissection of the ureter and bladder in adherent fat. After creating pneumoperitoneum and port placement, the ureter is exposed at the iliac crossing and dissected distally. Perivesical fat at the intended site of ureteric reimplantation is excised and cystotomy is done. Ureterovesical anastomosis is performed over a stent.
Two patients with pelvic lipomatosis causing ureteric obstruction and renal function impairment underwent robotic ureteric reimplantation at our institute. Technical aspects and outcomes are discussed here.
Blood loss was minimal. No intra-operative or post-operative complication was noted. Renal function improved for both patients.
Robotic approach helps to overcome the technical difficulties posed by adherent fat during ureteric reimplantation in pelvic lipomatosis.
输尿管再植术是治疗盆腔脂肪增多症合并输尿管梗阻的首选方法。盆腔粘连脂肪在该手术过程中带来了技术挑战。
我们描述了一种机器人辅助方法，以利于在粘连脂肪中精确解剖输尿管和膀胱。建立气腹并放置端口后，在髂血管交叉处暴露输尿管并向远端解剖。切除输尿管再植预定部位的膀胱周围脂肪并进行膀胱切开术。在支架上进行输尿管膀胱吻合术。
两名因盆腔脂肪增多症导致输尿管梗阻和肾功能损害的患者在我院接受了机器人辅助输尿管再植术。在此讨论技术要点和结果。
失血极少。未观察到术中或术后并发症。两名患者的肾功能均有所改善。
机器人辅助方法有助于克服盆腔脂肪增多症输尿管再植术中粘连脂肪带来的技术困难。
