NARUS 2018: Robotics and Reconstruction in 2018: Why It's Time
Robotic urologic reconstructive surgery enables us to perform pyeloplasty, redo-pyeloplasty, urinary bladder fistula closure and repair, primary ureteral anastomosis, grafting, psoas hitch, boari flap, pyelovesicostomy, ureteral fistula closure, ileal ureter, cystoprostatectomy for non functioning lower urinary tract, urinary bladder fistula closure and repair, simple prostatectomy and bladder neck reconstruction.
Keys for success in robotic urologic reconstructive surgery include safe entry into the abdomen (using visiport), meticulous exposure and identification of anatomy, reconstruction in healthy tissue, mobilization of the bladder to the ureter, tension free anastomosis, water tight closure, and usage of TilePro- as an additional tool to help guide dissection. When repairing a fistula, it is important to use cystoscopy, cannulation of both ureteral orifices, cannulation of the fistula, and placement of a Foley catheter.
In summary, robotic urologic reconstructive surgery enables achieving good outcomes. It is important to remember that it is not one size fits all, selection of the approach that best fits the patient should always be performed, and that the reconstructive principles should not be compromised.
Speaker: Jill Buckley, MD, UC San-Diego, USA
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV