Robot-assisted Ureteroureterostomy in the Adult: Initial Clinical Series

ObjectivesTo report what we believe is the first series of robot-assisted ureteroureterostomy (RAUU) in adults with greater than 24-month follow-up because ureteral stricture disease can be difficult to manage.MethodsDuring 2004-2006, a total of 3 patients were found to have complex ureteral pathology: 2 with refractory symptomatic ureteral strictures and 1 with a complete ureteral transection. After thorough discussion of all available treatment options, these patients agreed to undergo RAUU.ResultsAll patients had successful primary reanastomosis of the ureter robotically. Average operating room time was 136.6 minutes. Mean hospital stay was 3 days. All patients had ureteral stents placed during the operation. All patients at last follow-up were noted to be pain free with stable T½ on nuclear renal scan.ConclusionsRAUU is a potential treatment option for ureteral strictures in carefully selected patients. These cases may include failed endopyelotomy, refractory ureteral stricture, or cases of ureteral transection in which a ureteral reimplantation may be difficult. The robotic platform provides excellent reconstructive capabilities that may be difficult to obtain for surgeons who are not performing laparoscopic cases in high volume.