Robot-Assisted Laparoscopic Ileal Ureter

BACKGROUND AND OBJECTIVES: A patient with a solitary kidney, cysteine stones, and recurrent ureteral strictures underwent robot-assisted laparoscopic ureterectomy with ileal ureter formation. METHODS: Using a transperitoneal, 4-port robotic approach, we removed the strictured ureter and created an ileal ureter. The ileal-pyelo and ileal-vesical anastomoses were performed using the robotic system. An extracorporeal bowel anastomosis was performed using stapling devices. Operative time was 9 hours with negligible blood loss, and the patient was discharged after 5 days. RESULTS: A cystogram at 10 days demonstrated patent anastomoses without extravasation. The patient continues to do well 48 months later. CONCLUSION: Robot-assisted laparoscopic ileal ureter replacement is feasible with excellent long-term outcome.