#267 Bilateralureteral reimplantation after robotic radical cystectomy & Intracorp.Ileal Neobladder

This is one of the 2023 KS International Innovation Awards videos selected for inclusion in the Vattikuti Foundation – ORSI Humans on the Cutting Edge of Robotic Surgery Conference, October 6, 7 & 8, 2023 in Ghent, Belgium. Posting does not imply that is has been selected as a Finalist, just that the content will be discussed at the Conference.

From the entry: Bilateral ureteral reimplantation after robotic radical cystectomy and Intracorporeal Ileal Neobladder Sureda J. Narváez P. Martínez C. Carbonell E. Peri L. Ribal MJ. Alcaraz A. Musquera M.

INTRODUCTION: Uretero-enteric anastomosis represents one of the principal complications after radical cystectomy and the main cause of renal dysfunction after urinary diversion. In most cases, the gold standard treatment consist on open revision. This approach can result with significant morbidity . The robotic approach can be a minimally invasive treatment option for these patients.

MATERIALS & METHODS: A 64-year-old male with past history of muscle- invasive bladder tumor who underwent robotic radical cystectomy in June 2022. The surgical technique for urinary diversion consisted of an intracorporeal Y- shaped neobladder. Four months later, the patient presented with fever and bilateral lower back pain. The CT scan showed mild left-sided ectasia up to the uretero-enteric anastomosis and moderate right-sided ectasia with 2 cm of distal stenosis. It was decided to perform bilateral ureteral reimplantation using a robotic approach.

RESULTS: A robotic left direct ureteral reimplantation was performed, with an exteriorized ureteral catheter. On the right side a Boari-type reimplantation was carried out. The patient presented no postoperative complications. On the follow up presents a correct renal function, with correct image controls and no infection events.

CONCLUSION: Robotic ureteral reimplantation is a feasible option after robotic radical cystectomy in selected cases.

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