Robot-Assisted Surgery in Treating Postoperative Strictures of Lower Third of Ureter

Abstract

Introduction. The incidence of postoperative ureteral strictures induced by iatrogenic injuries tends to increase. Reconstructive surgery involves open or laparoscopic intervention to repair strictures. However, both methods have their drawbacks. Surgical treating strictures of the lower third of the ureter can be effectively performed by means of robotic surgery.Aim. To determine outcomes of robot-assisted reconstructive surgery in treating postoperative strictures of the lower third of the ureter.Materials and methods. Five female patients with postoperative strictures of the lower third of the ureter underwent robot-assisted reconstructive surgery. Clinical and radiological outcomes in the long-term postoperative period were determined.Results and discussion. Two patients underwent simultaneous robot-assisted reconstructive surgery, namely, robot-assisted uretero-cysto-neoanastomosis on the right side and Boari operation on the left; robot-assisted Boari operation and isolation of post-traumatic uretero-vaginal fistula. In the remaining three cases, robot-assisted Boari operation and uretero-cysto-neoanastomosis with psoas-hitch were performed. No evidence of ureteral stricture in all cases was detected via multislice spiral CT (MSCT) urography in 3 months after surgery.Conclusion. At present, robot-assisted reconstructive surgery, being suitable for simultaneous surgery, is safe and effective whentreating postoperative strictures of the lower third of the ureter.