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Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults

OBJECTIVE: To present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults. PATIENTS AND METHODS: We retrospectively reviewed all patients from our centre who underwent RAUC, between 2011 and 2015, for sec...

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Autores principales: Chhabra, Jaspreet S., Balaji Sudharsan, S., Singh, Abhishek, Mishra, Shashikant, Ganpule, Arvind, Sabnis, Ravindra, Desai, Mahesh R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767785/
https://www.ncbi.nlm.nih.gov/pubmed/26966590
http://dx.doi.org/10.1016/j.aju.2016.01.001
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author Chhabra, Jaspreet S.
Balaji Sudharsan, S.
Singh, Abhishek
Mishra, Shashikant
Ganpule, Arvind
Sabnis, Ravindra
Desai, Mahesh R.
author_facet Chhabra, Jaspreet S.
Balaji Sudharsan, S.
Singh, Abhishek
Mishra, Shashikant
Ganpule, Arvind
Sabnis, Ravindra
Desai, Mahesh R.
author_sort Chhabra, Jaspreet S.
collection PubMed
description OBJECTIVE: To present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults. PATIENTS AND METHODS: We retrospectively reviewed all patients from our centre who underwent RAUC, between 2011 and 2015, for secondary PUJO resulting from previous surgical intervention. Six procedures in five patients, including a bilateral RAUC were performed. The median (range) patient age was 33.7 (18–41) years. The outcome variables included operative time, duration of hospital stay, and objective evidence of unimpeded drainage on urography. RESULTS: The mean (range) operating time was 172 (144–260) min and estimated blood loss was 100 (50–250) mL. There were no conversions to open or laparoscopic surgery, and no intraoperative complications. Two patients had Clavien–Dindo Grade I complications that were managed conservatively and one patient had a Grade IIIb complication, which required balloon dilatation and re-stenting. After a median (range) follow-up of 11 (7–48) months, five of the six renal units had successful outcomes. CONCLUSION: The robot-assisted approach appears to be ideally suited for redo cases demanding fine dissection with meticulous suturing. In our present series of adult patients, we could safely and successfully perform RAUC with minimal morbidity. However, a larger multi-institutional outcome analysis is required to substantiate the role of the robot-assisted approach in performing UC.
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spelling pubmed-47677852016-03-10 Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults Chhabra, Jaspreet S. Balaji Sudharsan, S. Singh, Abhishek Mishra, Shashikant Ganpule, Arvind Sabnis, Ravindra Desai, Mahesh R. Arab J Urol Laparoscopy/Robotics Original article OBJECTIVE: To present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults. PATIENTS AND METHODS: We retrospectively reviewed all patients from our centre who underwent RAUC, between 2011 and 2015, for secondary PUJO resulting from previous surgical intervention. Six procedures in five patients, including a bilateral RAUC were performed. The median (range) patient age was 33.7 (18–41) years. The outcome variables included operative time, duration of hospital stay, and objective evidence of unimpeded drainage on urography. RESULTS: The mean (range) operating time was 172 (144–260) min and estimated blood loss was 100 (50–250) mL. There were no conversions to open or laparoscopic surgery, and no intraoperative complications. Two patients had Clavien–Dindo Grade I complications that were managed conservatively and one patient had a Grade IIIb complication, which required balloon dilatation and re-stenting. After a median (range) follow-up of 11 (7–48) months, five of the six renal units had successful outcomes. CONCLUSION: The robot-assisted approach appears to be ideally suited for redo cases demanding fine dissection with meticulous suturing. In our present series of adult patients, we could safely and successfully perform RAUC with minimal morbidity. However, a larger multi-institutional outcome analysis is required to substantiate the role of the robot-assisted approach in performing UC. Elsevier 2016-03 2016-02-08 /pmc/articles/PMC4767785/ /pubmed/26966590 http://dx.doi.org/10.1016/j.aju.2016.01.001 Text en © 2016 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Laparoscopy/Robotics Original article
Chhabra, Jaspreet S.
Balaji Sudharsan, S.
Singh, Abhishek
Mishra, Shashikant
Ganpule, Arvind
Sabnis, Ravindra
Desai, Mahesh R.
Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults
title Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults
title_full Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults
title_fullStr Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults
title_full_unstemmed Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults
title_short Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults
title_sort robot-assisted ureterocalycostomy: a single centre contemporary experience in adults
topic Laparoscopy/Robotics Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767785/
https://www.ncbi.nlm.nih.gov/pubmed/26966590
http://dx.doi.org/10.1016/j.aju.2016.01.001
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