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African Journal of Urology

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Robotic repair of retrocaval ureter: A case series

B Nayak, PN Dogra, NP Gupta

Abstract


Objective: To present our technique and experience of robotic repair of symptomatic retrocaval ureter.
Subjects and methods: This is a prospective case series of five consecutive patients who underwent robotic retrocaval ureter repair at our institute from August 2006 to September 2009. Pre-operative imaging included intravenous urogram, contrast enhanced CT scan and diuretic renography. All cases were done through a transperitoneal approach using 4 ports. Follow-up was done with intravenous urography and diuretic renography. Relevant data were collected and analyzed regarding perioperative morbidity, complications and functional outcomes.
Results: Five cases of robotic retrocaval ureter repair were performed. Four were male and one was female. The mean operative time was 92 min which included anastomosis time of 40 min. The mean estimated blood loss was 55 ml. The drain was removed on postoperative day 1 in all patients. The average hospital stay was 2 days. On average follow-up of 13.5 months all patients were pain free and renal dynamic scan showed non-obstructed clearance.
Conclusions: Robotic retrocaval ureter repair without excision of the retrocaval segment is feasible and an effective alternative to open or laparoscopic retrocaval ureter repair with good anatomical and functional outcome. It may become the procedure of choice along with laparoscopic surgery for retrocaval ureter.



http://dx.doi.org/10.1016/j.afju.2012.08.005
AJOL African Journals Online