Department of Surgery, Montefiore Medical Center, The Bronx, New York.
Department of Urology, Montefiore Medical Center, The Bronx, New York.
CRSLS. 2023 Sep 22;10(3). doi: 10.4293/CRSLS.2023.00020. eCollection 2023 Jul-Sep.
We report the case of a transplanted ureter obstructed by an inguinal herniation treated by a robotic-assisted approach.
This is a case of a 63-year-old male who had a kidney transplant with a graft on the left pelvis in September 2014, and presented to the clinic for evaluation of bilateral inguinal hernia. On physical examination he had bilateral palpable inguinal hernias, with the right one larger and only partially reducible. Computed tomography scan showed portion of urinary bladder and transplant ureter in the left inguinal hernia and mild hydroureteronephrosis in the transplanted kidney. Patient underwent catheterization of the transplant ureter where indocyanine green was injected for proper transplant ureter identification with the Firefly filter and robotic assisted hernia repair. Surgery was uneventful and patient was discharged home the same day with no further complications.
The robotic approach using the Firefly filter was shown to be safe during the dissection to avoid injury to the transplant ureter.
我们报告了一例机器人辅助手术治疗的疝入腹股沟导致移植输尿管梗阻的病例。
这例患者为 63 岁男性,于 2014 年 9 月接受左骨盆肾移植,因双侧腹股沟疝就诊。体格检查发现双侧可触及腹股沟疝,右侧较大且仅部分可复性。计算机断层扫描显示部分膀胱和移植输尿管位于左侧腹股沟疝内,移植肾轻度积水。患者行移植输尿管置管术,术中注射吲哚菁绿,使用 Firefly 过滤器和机器人辅助疝修补术正确识别移植输尿管。手术过程顺利,患者当天出院,无进一步并发症。
使用 Firefly 过滤器的机器人方法在分离过程中显示出安全性,可避免移植输尿管损伤。