Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-10-17 DOI:10.1002/rcs.2589

Xingyuan Xiao, Yuancheng Zhou, Shuaishuai Chai, Gong Cheng, Bing Li

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Abstract

Background

To describe the surgical technique of robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9-month follow-up outcomes.

Method

A longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension-free manner.

Results

Voiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9-month follow-up.

Conclusions

Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.

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机器人辅助阑尾上承式皮瓣输尿管成形术联合输尿管再植入术治疗多灶性输尿管狭窄：病例报告和技术描述。

背景：描述机器人辅助阑尾上承式皮瓣输尿管成形术联合输尿管再植入术一期修复单侧多灶性输尿管狭窄的手术技术，并报告9个月的随访结果。方法：对1号和2号输尿管近端狭窄进行纵向腹侧切口，并沿其反隔边界切除阑尾。然后，将阑尾上承皮瓣与飞溅的输尿管以上承方式吻合。为了治疗3号输尿管远端狭窄，以无张力的方式进行了输尿管再植入术。结果：术后7周，排尿性膀胱尿道造影和顺行尿路造影显示尿液反流至输尿管，无扩张，重建输尿管段无梗阻。在9个月的随访中，没有发生术后并发症。结论：机器人辅助阑尾上承式皮瓣输尿管成形术联合输尿管再植入术是一种安全有效的修复单侧多灶性输尿管狭窄的手术方法。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.