Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures
Abstract Background To summarize the efficacy of combined robot-assisted laparoscopy and ureteroscopy in treating complex ureteral strictures. Methods Eleven patients underwent combined robot-assisted laparoscopy and ureteroscopy for ureteral strictures between January 2020 and August 2022. Preopera...
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| Format: | Article |
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BMC
2023-10-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-023-01333-3 |
| _version_ | 1797556182337978368 |
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| author | Wenjin Yang Weinan Tang Xi Zheng Mengjie Zhang Xinyi Lu Zeqing Chen Changwei Ji Hongqian Guo |
| author_facet | Wenjin Yang Weinan Tang Xi Zheng Mengjie Zhang Xinyi Lu Zeqing Chen Changwei Ji Hongqian Guo |
| author_sort | Wenjin Yang |
| collection | DOAJ |
| description | Abstract Background To summarize the efficacy of combined robot-assisted laparoscopy and ureteroscopy in treating complex ureteral strictures. Methods Eleven patients underwent combined robot-assisted laparoscopy and ureteroscopy for ureteral strictures between January 2020 and August 2022. Preoperative B-ultrasound, glomerular filtration rate measurement, and intravenous pyelography showed different degrees of hydronephrosis in the affected kidney and moderate to severe stenosis in the corresponding part of the ureter. During the operation, stricture segment resection and end-to-end anastomosis were performed using the da Vinci robot to find the stricture point under the guidance of a ureteroscopic light source in the lateral or supine lithotomy position. Results All the patients underwent robot-assisted laparoscopy and ureteroscopy combined with end-to-end ureterostenosis. There were no conversions to open surgery or intraoperative complications. Significant ureteral stricture segments were found in all patients intraoperatively; however, stricture length was not significantly different from the imaging findings. Patients were followed up for 3–27 months. Two months postoperatively, the double-J stent was removed, a ureteroscopy was performed, the ureteral mucosa at the end-to-end anastomosis grew well, and the lumen was patent in all patients. Furthermore, imaging examination showed that hydronephrosis was significantly improved in all patients, with grade I hydronephrosis in three cases and grade 0 hydronephrosis in eight cases. No recurrence of ureteral stricture was observed in patients followed up for > 1 year. Conclusion Robot-assisted laparoscopy combined with ureteroscopy is an effective method for treating complex ureteral strictures and can achieve accurate localization of the structured segment. |
| first_indexed | 2024-03-10T16:58:17Z |
| format | Article |
| id | doaj.art-b63f94fec9c64232a1e338ce1e80ae14 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-10T16:58:17Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-b63f94fec9c64232a1e338ce1e80ae142023-11-20T11:03:17ZengBMCBMC Urology1471-24902023-10-012311910.1186/s12894-023-01333-3Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral stricturesWenjin Yang0Weinan Tang1Xi Zheng2Mengjie Zhang3Xinyi Lu4Zeqing Chen5Changwei Ji6Hongqian Guo7Department of Urology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Urology, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical UniversityDepartment of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Urology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Urology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Urology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineAbstract Background To summarize the efficacy of combined robot-assisted laparoscopy and ureteroscopy in treating complex ureteral strictures. Methods Eleven patients underwent combined robot-assisted laparoscopy and ureteroscopy for ureteral strictures between January 2020 and August 2022. Preoperative B-ultrasound, glomerular filtration rate measurement, and intravenous pyelography showed different degrees of hydronephrosis in the affected kidney and moderate to severe stenosis in the corresponding part of the ureter. During the operation, stricture segment resection and end-to-end anastomosis were performed using the da Vinci robot to find the stricture point under the guidance of a ureteroscopic light source in the lateral or supine lithotomy position. Results All the patients underwent robot-assisted laparoscopy and ureteroscopy combined with end-to-end ureterostenosis. There were no conversions to open surgery or intraoperative complications. Significant ureteral stricture segments were found in all patients intraoperatively; however, stricture length was not significantly different from the imaging findings. Patients were followed up for 3–27 months. Two months postoperatively, the double-J stent was removed, a ureteroscopy was performed, the ureteral mucosa at the end-to-end anastomosis grew well, and the lumen was patent in all patients. Furthermore, imaging examination showed that hydronephrosis was significantly improved in all patients, with grade I hydronephrosis in three cases and grade 0 hydronephrosis in eight cases. No recurrence of ureteral stricture was observed in patients followed up for > 1 year. Conclusion Robot-assisted laparoscopy combined with ureteroscopy is an effective method for treating complex ureteral strictures and can achieve accurate localization of the structured segment.https://doi.org/10.1186/s12894-023-01333-3Ureteral stricturesRobot-assisted surgeryUreteroscopySurgical techniqueEnd-to-end anastomosis |
| spellingShingle | Wenjin Yang Weinan Tang Xi Zheng Mengjie Zhang Xinyi Lu Zeqing Chen Changwei Ji Hongqian Guo Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures BMC Urology Ureteral strictures Robot-assisted surgery Ureteroscopy Surgical technique End-to-end anastomosis |
| title | Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures |
| title_full | Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures |
| title_fullStr | Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures |
| title_full_unstemmed | Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures |
| title_short | Combination of robot-assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures |
| title_sort | combination of robot assisted laparoscopy and ureteroscopy for the management of complex ureteral strictures |
| topic | Ureteral strictures Robot-assisted surgery Ureteroscopy Surgical technique End-to-end anastomosis |
| url | https://doi.org/10.1186/s12894-023-01333-3 |
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